A 30-year-old man presented with a swelling in the testis and an ultrasound scan confirmed the presence of a malignant mass. Following orchidectomy, he was found to have a 40-mm seminomatous germ cell tumour without non-seminomatous components. There was evidence of vascular invasion within the testis.Investigations: serum lactate dehydrogenase (LDH) 1250 U/L (10-250) serum ?-fetoprotein normal serum ?-human chorionic gonadotrophin (HCG) 700 U/L (<5) A CT scan of body showed retroperitoneal lymphadenopathy of up to 7 cm in size, a 3- cm mediastinal lymph node and over 30 pulmonary metastases. There were no signs of liver, brain or bone metastases. What is the most appropriate International Germ Cell Cancer Collaborative Group classification?
A) good prognosis because of the absence of liver, bone and brain metastases
B) good prognosis because of the raised HCG and LDH
C) intermediate prognosis because of the presence of lung metastases
D) intermediate prognosis because of the raised serum HCG and LDH
E) poor prognosis because of the raised serum HCG and LDH
Correct Answer:
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