Node growth rate?

[Rover]

I am currious if there is such a thing as anticipated growth rate for node mets? In another thread I read para-aortic nodes are a landing site for lefty TC. This got my attention because I remebered some language on my CT reports.

So, over several CTs in the last 2 years this is what I’m looking at:

Oct 2005 “Few shotty retroperitoneal lymph nodes, left para-aortic in location, none of which measure more than 7mm x 4mm in size.”
Doc said this is likely viral in nature.

This is carried on the next couple reports with statements referring to the left para-aortic nodes as being “stable”, “subcentimeter” and “unchanged”.

More recent CTs report a left para-aortic node as “unchanged” but measured at 6x10 April 2007 and most recently the December 2007 CT report says “A left para-aortic node was previously measured at 10x6mm. This is once again identified and measures approximatley 8x11mm. No concerning findings are noted.”

So my questions are:
Given my left predominantly teratoma pathology what is the expected rate of growth?
The growth appears to be very slow and minimal. I’d be surprised if they can even measure this small a change with any accuracy. Is this within a margin of error for CTs.
Could it be that I am perfectly healthy and the radiologist is just digging for something to fill out the report?

In any event, I see my Onc next week and will discuss with him further but would like to get input from my extended TC family.

LiveSTRONG guys,
-chris

[TCLEFT]

Hey Chris,
I can't answer your question about rate of growth, but I can tell you a couple of things about my case. My primary Onc thinks my Mediastinal LN mass was a met. The Onc I saw briefly at Fox Chase thought it was a second occurance. Since the mass was pressing on my thoracic spinal column, and was mostly dorsal to the trach/esoph/aorta before wrapping around, he thought this would be a prime path for residual embryonal tissue. That's the exact path that the developing gonads take in the fetus before forming into either testes or ovaries. My primary Onc thought it could be a renegade met that escaped radiation. Mosher from MSK wouldn't venture to guess. None of my blood work picked up the liver mass. If it wasn't for the fact that I couldn't swallow without pain, I wouldn't be writing this to you. What I thought was reflux led me to have an endoscopy. The next day the pain was through the roof. Gastroenterologist called to see how I was and threatened to call an ambulance if I didn't get my a$$ to the ER. Someone there looked up my history, ordered a CT that found a tennis ball in my chest and golf balls in my liver (odd, I never played either). Anyway, like I told c-w, I'd think the best way to check on this would be a PET scan to look for activity in these areas. Don't know if the Onc and insurance would go for it, but I'd at least bring up your concern. My experience has been they tend to listen a little closer if you weren't cooperative enough to stop growing crap after the first time.

[Fed]

Great to hear from you Chris!

Teratoma is a slow-grower, since it's behavior mimics that of a normal cell. Cancerous nodes are usually larger than 1 cm, somewhat misshaped, and containing odd-looking surroundings (I learned this from my oncologist last week). That said, I'm sure your doc will be keeping an eye on this just in case. How much teratoma was there in your pathology in relation to EC and yolk sac?

As far as the landing zones and normal nodes, there's this phrase I keep seeing in every single one of my radiology reports: "There are several stable subcentimeter retroperitoneal lymph nodes." My doc says that as long as they don't get bigger or start looking funny, then there's nothing to worry about.

Hope this helps Bro. Take care!

[Fed]

I'd think the best way to check on this would be a PET scan to look for activity in these areas.
This probably wouldn't be useful. Teratomas are not PET-active. That's why PET scans are never conclusive when non-seminomas are part of the equation. With seminomas it's OK because any mass that does not light up is likely to be necrotic tissue.

[TCLEFT]

This probably wouldn't be useful. Teratomas are not PET-active. That's why PET scans are never conclusive when non-seminomas are part of the equation. With seminomas it's OK because any mass that does not light up is likely to be necrotic tissue.
There goes that short attention span of mine again. c-w's was Seminoma. Keep me honest Bro.