Serum Lactate Dehydrogenase (LDH) is the Prognostic Marker in Cases with Presence of Psammoma Bodies

In cases with the presence of psammoma bodies, serum lactate dehydrogenase (LDH) is the marker with significant prognostic value. 1

Understanding Psammoma Bodies and Their Prognostic Significance

Psammoma bodies are concentric laminated calcified structures that can be found in various conditions, most notably in papillary thyroid carcinoma, ovarian serous carcinomas, and meningiomas 2
The presence of psammoma bodies has been associated with aggressive tumor behaviors including multifocality, extrathyroidal extension, and lymph node metastasis in papillary thyroid carcinoma 2
Psammoma bodies may mark the site of previous tumor and can sometimes appear more numerous because their density increases in areas where tumor has disappeared following treatment 1

LDH is the marker with established prognostic significance in cases with psammoma bodies, as it correlates with tumor burden, treatment response, and survival 1
Elevated LDH levels are associated with poorer outcomes and can be used to monitor disease progression and treatment response 1
LDH is particularly valuable as it reflects tumor cell turnover and can indicate ongoing disease activity even when imaging studies show regression 1

Alpha-fetoprotein is primarily associated with germ cell tumors and hepatocellular carcinoma but lacks specific prognostic value in conditions characterized by psammoma bodies 1
Human chorionic gonadotropin is valuable in gestational trophoblastic disease and certain germ cell tumors but is not specifically linked to psammoma body-containing tumors 1
Alkaline phosphatase of hepatic origin is more relevant to bone metastases and liver disease rather than conditions with psammoma bodies 1
Testosterone level has no established prognostic significance in tumors characterized by psammoma bodies 1

Serial measurements of LDH should be performed to monitor disease progression and treatment response in patients with psammoma body-containing tumors 1
A rising LDH level may indicate disease progression or treatment failure, warranting reassessment of the therapeutic approach 1
The Chemotherapy Response Score (CRS) system, which considers the presence of psammoma bodies, can be used alongside LDH measurements to assess treatment response 1

In papillary thyroid carcinoma, LDH levels correlate with the presence of psammoma bodies and ultrasonographic intratumoral calcifications, both of which are associated with nodal metastasis 2
In ovarian serous carcinomas, LDH levels together with the presence of psammoma bodies can help predict response to chemotherapy and overall survival 1
In meningiomas with psammoma bodies, LDH can serve as a marker for monitoring recurrence 1

When evaluating prognostic markers in tumors with psammoma bodies, it's essential to consider the specific tumor type, stage, and treatment history 1
Multiple measurements of LDH over time provide more valuable prognostic information than a single determination 1
Interpretation of LDH levels should take into account other clinical and pathological factors, including the extent of psammoma body formation 1