AFP (alpha-fetoprotein) is elevated in which of the following clinical scenarios EXCEPT:

• A Hepatocellular carcinoma
• B Yolk sac tumor (endodermal sinus tumor)
• C Neural tube defects (maternal serum AFP)
• D Seminoma (pure) ✓

Explanation

AFP is elevated in hepatocellular carcinoma (marker of hepatic origin), yolk sac tumors (which produce AFP as they recapitulate embryonic yolk sac), and maternal serum AFP is elevated in neural tube defects (due to leakage of fetal AFP through the neural tube defect into amniotic fluid). Pure seminoma (classic seminoma) does NOT produce AFP — it may produce beta-hCG in syncytiotrophoblastic cells but never AFP. Elevation of AFP in a supposed seminoma should raise suspicion for a mixed germ cell tumor with yolk sac component, warranting re-examination of pathology.

Reference: Harper's Illustrated Biochemistry, 32nd ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.