In patients for whom a diagnosis of germ cell tumor is suspected, the standard approach has been to obtain intracranial imaging, to sample serum and cerebral spinal fluid (CSF) for gold standard tumor markers (AFP and bHCG) and less commonly placental alkaline phosphatase (PLAP)10–13, and to have baseline endocrine and ophthalmologic evaluations. The gene discussed is ALPP; the disease is testicular germ cell tumor.