Which tumor increases hCG only?

• A. Hepatocellular carcinoma
• B. Choriocarcinoma
• C. NSGCT
• D. Gonadal tumor

Answer: (B)

The concept being tested is how certain tumors secrete hormone markers, with some tumors showing a single dominant marker. Choriocarcinoma is a malignant germ cell tumor composed of trophoblastic tissue that mimics placental cells, and it secretes large amounts of human chorionic gonadotropin (hCG). Because these tumor cells function like placental tissue, hCG becomes the defining elevated marker, often with little or no increase in other markers such as AFP.

Hepatocellular carcinoma, while it can have various marker patterns, is classically associated with alpha-fetoprotein rather than hCG as the primary signal. Non-seminomatous germ cell tumors can produce both hCG and AFP depending on the specific components (embryonal, yolk sac, etc.), so they are not characterized by hCG elevation alone. Gonadal tumors cover a broader range and may secrete hCG in some cases, but not exclusively.

Thus, the tumor that characteristically increases hCG only is choriocarcinoma.