Scrotal mass laboratory studies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Sujit Routray, M.D. [2]

Laboratory Findings

Complete Blood Count

Complete blood count (CBC) measures the number and quality of white blood cells, red blood cells, and platelets. A CBC is done to check the general health of the patient.

Blood Chemistry Tests

• Blood chemistry tests that are used to diagnose the cause of scrotal mass include the following:

• Liver function tests, or a liver panel, may be done to find out what is causing abdominal pain or discomfort. High levels of certain substances in the blood may mean that seminoma has spread to the liver.
• Kidney function tests are used to check how well the kidneys are working. They are often done, before and after orchiectomy.

• Blood chemistry test are often done in preparation for evaluation of scrotal mass where they create a baseline, used to compare future levels.

Tumor Marker Tests

• Serum tumor marker tests are generally used to check the response to cancer treatment. They can also be used to diagnose testicular cancer.
• The following tumor markers may be measured for testicular seminoma.

• Classical or pure seminoma do not cause an elevated serum alpha fetoprotein.
• Lactate dehydrogenase (LDH) may be the only marker that is elevated in some seminomas. The degree of elevation in the serum LDH has prognostic value in advanced seminoma. High LDH levels can indicate that the tumor is large, there is a large amount of cancer in the body, or the cancer is growing quickly. High levels can also mean that a man has advanced seminoma. LDH may also be high with some non-cancerous conditions.
• Human chorionic gonadotropin (hCG) may be elevated in some cases, but this correlates more to the presence of trophoblast cells within the tumor. HCG can also be high, if the man has liver disease.
• Blood tests may detect the presence of placental alkaline phosphatase (PLAP) in 50% of cases. However, PLAP cannot usefully stand alone as a marker for seminoma and contributes little to follow-up, due to its rise with smoking.