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Genitourinary Cancers • Pediatric Hematology/Oncology • Medical Oncology • Testicular Cancer
Is it unusual to have isolated LDH elevation and normal HCG and AFP in non-seminomatous germ cell tumor (embryonal carcinoma)?
In a patient s/p orchiectomy and with pelvic lymphadenopathy, would you consider lymph node biopsy to confirm involvement by non-seminomatous germ cell tumor rather than an unexpected lymphoma before initiating chemotherapy?
Answer from: Medical Oncologist at Academic Institution
It's hard to generalize: the details of the case matter. It is not very unusual to have an isolated LDH elevation. LDH is extremely non-specific. 101 different things can make LDH go up and this limits its usefulness as a tumor marker. Elevation of LDH on day 1 of cycle one of first-line chemotherap...
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Answer from: Medical Oncologist at Academic Institution
I agree completely with @Timothy D. Gilligan. After initial workup, I rarely obtain serum LDH as it is not a true "marker" like hCG and AFP. Simple things like recent trauma (or surgery), vigorous sports, or, if on chemo, even neulasta can elevate LDH. Finally, in the absence of undescended testis, ...