FALSE ELEVATIONS OF ALPHA-FETOPROTEIN ASSOCIATED WITH LIVER DYSFUNCTION IN GERM-CELL TUMORS

Background. Determination of serum concentration human chorionic gonad otropin (HCG) and alpha-fetoprotein (AFP) is crucial in diagnosis, pro gnosis, treatment, and follow-up of patients with germ cell tumors. El evation of these markers almost indicates progression or recurrence of the germ cell tumor. However, an increase in these tumor markers can be produced by several benign causes. Methods. The authors report nine cases of gonadal germ cell tumors that had increased serum levels of AFP without tumoral progression, recurrence, or residual tumor. Result s. The AFP elevations were attributed to liver damage secondary to dru gs (chemotherapy, anesthetics, or antiepileptics), virus, or alcoholis m. No clinical evidence o(r in some cases surgical evidence) of malign ant tumor activity was found in any of the patients. Conclusions. The elevation of serum levels of AFP in patients with germ cell tumors can be produced by liver dysfunction. These elevations must be interprete d with caution to avoid unnecessary treatments.