A PATIENT PRESENTS WITH A TESTICULAR MASS. YOU CARRY OUT A FULL CLINICAL EXAMINATION, CARRY OUT SOME BLOOD TESTS AND ARRANGE FOR FURTHER INVESTIGATIONS. WHICH BLOOD TESTS WOULD BE PARTICULARLY USEFUL IN HELPING YOU MAKE THE DIAGNOSIS

• A. CA-125
• B. Cytogenetics
• C. Lactate dehydrogenase, α-fetoprotein and β-human chorionic gonadotrophin ✓
• D. Carcinoembryonic antigen

To make an accurate diagnosis for a patient presenting with a testicular mass, several blood tests can be particularly useful. These tests help to identify specific markers that can indicate the presence of testicular cancer or other conditions. The correct answer for the provided question is:

C. Lactate dehydrogenase (LDH), α-fetoprotein (AFP), and β-human chorionic gonadotrophin (β-HCG)

Let’s examine why these tests are crucial for testicular mass diagnosis:

• Lactate dehydrogenase (LDH): LDH is an enzyme found in various body tissues, including testicular tumors. High LDH levels may indicate widespread disease. However, it’s important to note that LDH levels can also be increased due to some non-cancerous conditions.
• α-fetoprotein (AFP): AFP is a protein produced in the liver of a fetus during pregnancy. In adults, AFP is produced by certain types of testicular tumors, specifically non-seminomas. An increase in AFP levels can indicate the presence of non-seminoma testicular cancer.
• β-human chorionic gonadotrophin (β-HCG): β-HCG is a hormone produced by the placenta during pregnancy. In testicular cancer, some tumors produce β-HCG, including both seminomas and non-seminomas. An increase in β-HCG levels can indicate the presence of testicular cancer.

By examining the levels of these three markers, healthcare professionals can better understand the nature of the testicular mass and make informed diagnostic and treatment decisions.

In other words, when a patient presents with a testicular mass, several blood tests can be particularly useful in helping make a diagnosis. Among the options provided, the blood tests of lactate dehydrogenase (LDH), α-fetoprotein (AFP), and β-human chorionic gonadotropin (β-hCG) are commonly used in the evaluation of testicular masses.

LDH is an enzyme that is often elevated in patients with testicular cancer. AFP is a protein that may be elevated in certain types of testicular cancer, such as nonseminomatous germ cell tumors. β-hCG is a hormone that can also be elevated in some types of testicular cancer, particularly choriocarcinoma and embryonal carcinoma.

These blood tests, when used in conjunction with other diagnostic tools such as imaging studies like ultrasound or CT scans, can help healthcare providers determine the nature of the testicular mass and guide further management.