A 20 year old man has a testicular mass, which on orchiectomy shows a malignant tumor with yolk sac differentiation. Which of the following tumor markers would probably be most useful in monitoring the patient for recurrent or metastatic disease?

Of the markers listed, alpha-fetoprotein is the best marker for non-seminomatous germ cell tumors of the testes, such as this patient's yolk sac tumor. Alpha-fetoprotein is also a good marker for hepatocellular carcinomas. Bombesin is a marker for neuroblastoma, small cell carcinomas, gastric carcinomas, and pancreatic carcinomas. CEA (carcinoembryonic antigen) is a nonspecific marker, but has the advantage that it is produced by about 70% of colorectal and pancreatic cancers. It is also produced by some gastric and breast cancers. PSA (prostatic specific antigen) is a marker for prostatic carcinoma. Ref: Wyatt C., Butterwoh IV J.F., Moos P.J., Mackey D.C., Brown T.G. (2008). Chapter 17. Pathology of the Male and Female Reproductive Tract and Breast. In C. Wyatt, J.F. Butterwoh IV, P.J. Moos, D.C. Mackey, T.G. Brown (Eds),Pathology: The Big Picture.