12-28-2011, 03:17 PM
288) A 38 year old caucasian man is seen in the office during a routine follow up visit. His past medical history is significant for testicular non-seminomatous germ cell tumor diagnosed 9 months ago and was treated with radical orchiectomy of left testicle and chemotherapy. He completed chemotherapy 6 months ago and achieved a complete response. His tumor markers and imaging studies 3 months after completion of therapy were normal. He complains of decreased sexual drive and energy. He denies smoking tobacco or alcohol. He uses Marijuana on a daily basis but quit 2 months ago. His family history is unremarkable. Physical examination shows absent left testicle. Rest of the physical is normal. Serum alpha-fetoprotein is normal. Beta HCG is elevated at 15U/L ( Normal < 5 U/L) . A chest X-ray , CT scan of the abdomen and pelvis are normal. His routine laboratory investigations including complete blood count are within normal limits. Which of the following is most likely reason for his elevated Beta-HCG?
A) Recurrent tumor
B) Marijuana Use
C) Hypogonadism
D) Chemotherapy effect
E) Hyperthyroidism
A) Recurrent tumor
B) Marijuana Use
C) Hypogonadism
D) Chemotherapy effect
E) Hyperthyroidism