A 28-year-old man presents with a right testicular mass. Tumour markers show: AFP 1800 ng/mL, beta-hCG 2000 IU/L, LDH 1.5× upper limit of normal. CECT reveals 4 retroperitoneal lymph nodes each <2 cm and no visceral metastases. According to IGCCC classification, his prognosis group is:
- A Intermediate prognosis
- B Poor prognosis
- C Good prognosis ✓
- D Intermediate prognosis — requires AFP >10,000 for good prognosis classification
Correct answer: C. Good prognosis
Explanation
The IGCCC (International Germ Cell Cancer Collaborative Group) good-prognosis category for non-seminomatous GCT requires ALL of: testis or retroperitoneal primary, no non-pulmonary visceral metastases, AFP <1000 ng/mL, beta-hCG <5000 IU/L, and LDH <1.5× ULN. This patient has AFP 1800 ng/mL (which exceeds 1000 ng/mL) but is below the intermediate threshold of 10,000 ng/mL, placing him in the intermediate prognosis group. Intermediate NSGCT requires AFP 1000–10,000, or hCG 5000–50,000, or LDH 1.5–10× ULN with gonadal/retroperitoneal primary.
Reference: Bailey & Love's Short Practice of Surgery, 27th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.