I am a male. I have discovered a lump in my right chest area, just below my nipple. It appears to be roughly 3-5 cm in diameter, movable against all surrounding tissue, and it feels smooth, even-shaped, and firm but not hard, rather elastic. No pain, no visible changes from outside. I am 49 years old and have the following established preexisting conditions like Hashimoto's, slight hypertension, migraines since childhood, and some allergies. I do have recurrent episodes of polyuria for many years that were diagnosed as stress-related some years ago after all differentials had been excluded.
A blood panel ordered by my GP now returns a slightly elevated free beta HCG level (3.24 mIU/ml with a reference value of 3.0 for males). All other results including CBC are normal, PSA and AFP, as well as HCG are negative, sexual hormones panel is normal. I cannot detect any abnormalities with my testicles.
I understand that any detected beta HCG in males indicates a malignancy. How worried should I be?
Welcome to icliniq.com.
First of all, I must say you have written your history very well.
What I searched and concluded is:
1. About your HCG (human chorionic gonadotropin) level, your b-HCG is raised while total HCG is normal. Get it repeated from some other lab, if still raised then proceed to step 2 and 3.
2. Get ultrasound scrotum (to see for any hyoechoic areas or area of calcification).
3. Get FNAC (fine needle aspiration cytology) or excision biopsy of 3-5 cm lesion below your nipple.
I understand that any detected beta HCG in males indicates a malignancy. How worried should I be? To answer this question, I was just wondering why you got HCG done in first place as you were asymptomatic?
Neither of the drugs you are taking does not interfere with this test (b HCG). You cannot just ignore and sit on it (if b-HCG is deranged), you have to find a cause be it faulty lab investigation itself.
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Thank you doctor,
My GP had ordered the tests on the suggestion of his urology consult as apparently some rare testicular tumors may cause gynecomastia, over diagnosing is a little bit a thing here, I may add.
I have now heard back from the local urologist (who works with this specific lab and is rather hard to contact what with the Corona situation). He will do an ultrasound next week and will decide on a biopsy after thorough palpation of the lesion. He now tells me that for him the beta HCG is within normal range, especially in the absence of any other changes in the blood work, the negative total HCG and the lack of specific symptoms.
Just to calm my anxiety over the weekend. is his assessment fair in your opinion?
Welcome back to icliniq.com.
Yes, I think just because it is out of range (that too not very much) makes you suspect for malignancy. I still feel repeat it from the best lab you have access to in your place, and if still raised we just screen for the malignancies in which it is raised most common of all is testis (so just follow step 2 and 3).
I accept the opinion of your local urologist (that you are absolutely normal). Kindly keep me informed about the further investigations you do.
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