A 29-Year-Old Man Comes to the Office Due to Increased

A 29-year-old man comes to the office due to increased sweating, heat intolerance, insomnia, and unintentional weight loss over the past 4 weeks.  The patient has also noticed that his right testis feels bigger than the left but has had no scrotal pain.  He has no prior medical problems and takes no medications.  The patient does not use tobacco, alcohol, or illicit drugs.  Blood pressure is 121/71 mm Hg and pulse is 108/min.  On examination, the thyroid is mildly enlarged.  Testicular examination reveals an enlarged, nontender right testicle.  Laboratory testing shows elevated serum thyroxine and triiodothyronine levels.  Scrotal ultrasonography demonstrates a hypoechoic mass within the right testicle.  Elevated levels of which of the following substances would most likely explain this patient's symptoms?

A) Alpha-fetoprotein
B) Follicle-stimulating hormone
C) Human chorionic gonadotropin
D) Lactate dehydrogenase
E) Placenta-like alkaline phosphatase

Correct Answer:

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