UNUSUAL PULMONARY MANIFESTATION IN ADVANC ED TESTICULAR CANCER

A case of unusual pulmonary manifestation in advanced testicular cance r is presented where only pathohistological findings after primary pne umonectomy led to urological examination and diagnosis of the underlyi ng testicular tumor. This course of events may serve as an example for recurrent problems in the systematic diagnosis and treatment of advan ced testicular cancer, resulting from increasing specialization in the medical field. A constant slight elevation of the tumor marker AFP co uld be explained by a disturance of the immunological test system due to nonspecific binding of heterophilic antibodies. Other reasons and d iagnostic tools for the evaluation of persistently elevated (''false-p ositive'') AFP-tumor marker values are discussed. In the last two deca des, efficient programs for diagnosis, treatment and follow-up of germ inal testicular cancer have been established and standardized. As the present case substantiates, however, especially advanced stages of the disease may still represent a diagnostic and therapeutic challenge ne cessitating early communication between medical departments in order t o coordinate the diagnostic and therapeutic strategy in each individua l patient.