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Surgery General 343f8dd4

All of the following clinicopathologic features are seen more often in seminomas as compared to non-seminomatous germ cell tumors of the testis except:

A
Tumors remain localized to testis for a long time
B
They are radiosensitive
C
They metastasize predominantly by lymphatics
D
They are often associated with raised levels of serum AFP and HCG
High-Yield Explanation
"While hCG concentration may be inceased in patients with either nonseminoma or seminoma histology, the AFP concentration is increased only in patietns with nonseminoma." - Harrison Seminomas represent about 50% of all Germ cell tumors of testis. Median age is 4th decade (Nonseminomas are most frequent in the 3rd decade). Seminomas follow a more indolent course. Most seminomas (70%) present with stage I disease (disease limited to testis), about 20% with stage II disease (with retroperitoneal metastases), and 10% with stage III disease (spread beyond retroperitoneum) Seminomas as well as non-seminomas typically metastasize through lymphatics (except Choriocarcinoma which demonstrates early hematogenous spread) Seminomas are one of the most radiosensitive tumors (Non seminomas are insensitive to radiation).

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