Abstract
Alpha fetoprotein (AFP) at a level of 250 times its very low normal level in adults is characteristic or diagnostic of hepatoma or teratoma one of which is testicular tumor. Immunochemical methods are used for AFP detection. 75% of a review series were found positive for AFP using autoradioautography; with newer more sensitive radioimmunoassay techniques as many as 85% should be diagnosed. The clinical applications of positive AFP determinations include ruling out of simple epididymo-orchitis and assigning of an anaplastic tumor to the teratoma series. To date no attempt to study the prognostic value of positive AFP in testicular tumors has been reported but in an informal presentation of personal cases 11/17 positive AFPs were anaplastic tumors; of 8 deaths 7 were positive for AFP suggesting a poorer prognosis if AFP is present. AFP level determination will help in treatment selection for if a patient has a positive AFP before orchidectomy and it remains elevated after then there must be metastases.
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