Histologically pure stage I seminoma with an elevated beta-hCG of 4497 IU/l

Approximately 30% of patients with pure seminoma of the testis have mild elevation of human chorionic gonadotropin (hCG) due to the presence of syncytiotrophoblastic giant cells. Levels are usually less than 500 IU/L; however, the occurrence of higher levels is rare. We report a case of a man with a stage I histologically pure seminoma, copious syncytiotrophoblast cells, and a serum beta human chorionic gonadotropin (beta-hCG) of 4497 IU/L. To our knowledge this is the third highest value of beta-hCG reported with a stage I pure seminoma. The patient underwent an orchiectomy and chemotherapy. His beta-hCG level was undetectable by postoperative day 13, and he remains disease free at 30 months.