This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Surgery
All of the following clinicopathologic features are seen more often in seminomas as compared to non-seminomatous germ cell tumors of the testis except: 
Select and explain. 
A. Tumors remain localized to testis for a long time, B. They are radiosensitive, C. They metastasize predominantly by lymphatics, D. They are often associated with raised levels of serum AFP and HCG
D: They are often associated with raised levels of serum AFP and HCG
Answer: D: They are often associated with raised levels of serum AFP and HCG 
Explanation: "While hCG concentration may be inceased in patients with either nonseminoma or seminoma histology, the AFP concentration is increased only in patietns with nonseminoma." - Harrison

Seminomas represent about 50% of all Germ cell tumors of testis.
Median age is 4th decade (Nonseminomas are most frequent in the 3rd decade).

Seminomas follow a more indolent course.

Most seminomas (70%) present with stage I disease (disease limited to testis),
about 20% with stage II disease (with retroperitoneal metastases),
and 10% with stage III disease (spread beyond retroperitoneum)



Seminomas as well as non-seminomas typically metastasize through lymphatics (except Choriocarcinoma which demonstrates early hematogenous spread)
Seminomas are one of the most radiosensitive tumors (Non seminomas are insensitive to radiation).