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  • Need opinions / advice STAT

    I previously posted this in the wrong forum so, here it is now....


    Well, got the results from the sonogram and tumor markers. I'm hoping someone can translate this into English for me. To me, the tumor markers are within normal range, but my Dr. said that although the tests rule out certain types of cancers, they don't tell him its NOT cancer, and the surgery must still happen. I've had the all pre-op screening tests done and am having a final consult with him on Friday. My surgery is scheduled for this Monday, the 25th.


    So, my question is this: Based on the fact that all of my tumor makers are normal and the sonogram shows something, but nothing definitive, is an I/O really necessary?

    AFP : 5.8 (ref. range <6.1)
    HCG: <2 (ref. range <5)
    LDH : 570 (ref. range 313-618)

    Right measures 5.3 X 2.7 X 4.0 cm It is diffusely heterogeneous is echotexture with lobulated contours. It is unclear whether this represents a large mass, multiple adjacent masses or a conlfuent infiltrative process. It is vascular. Aterial and venous flow is demonstrated. The right epididymal head measures 2 cm. in diameter. It contains 2 adjacent versus a septated cyst measuring 1.8 cm. There is no right hydrocele. There is no variocele.
    Left measures 4.4 X 1.9 X 2.6 cm. It is minimslly heterogeneous in echotexture. arterial and venous flow is demonstrated. The epididymal head measures 0.8 in diameter. There is no left hydrocele. There is no variocele.

    Impression: 1. Enlarged hetergeneous right testicle. In the proper clinical setting, this could represent infection, but concerning for neoplastic process. Clinical correlation is warranted.
    2. Right Epididymal head cyst / cysts.
    9/14/17 Pre I/O markers : AFP 5.8 / HCG <2 / LDH 570
    9/18/17 Chest X-Ray
    9/25/17 Right I/O surgery
    Unifocal Seminoma 5cm. Tumor invades rete testis; Stage T1B
    No evidence of lymphovascular invasion.

    10/2/17 Scrotal hematoma corrective surgery.
    10/3/17 CT scan shows no lymph node involvement.

  • #2
    I'm copying & pasting what I posted in the other thread, it is best to not duplicate posts, however, it just makes it hard to follow a conversation if it's jumping all over the forum:

    Well this is the key:
    diffusely heterogeneous is echotexture


    It doesn't actually mean it's TC, but it might well be. A normal testicle would appear homogeneous (IE look the same everywhere). Yours appears to contain several different tissue types. The only safe thing to do is get the surgery & find out for sure. The peace of mind will be worth it.

    As far as tumor markers, they are only useful when elevated, which pretty much says you do have TC. Normal markers are useless & tell us nothing. Many guys here had TC with normal markers.

    Dave
    Jan, 1975: Right I/O, followed by RPLND
    Dec, 2009: Left I/O, followed by 3xBEP

    Comment


    • #3
      Ok. Thanks Dave.
      9/14/17 Pre I/O markers : AFP 5.8 / HCG <2 / LDH 570
      9/18/17 Chest X-Ray
      9/25/17 Right I/O surgery
      Unifocal Seminoma 5cm. Tumor invades rete testis; Stage T1B
      No evidence of lymphovascular invasion.

      10/2/17 Scrotal hematoma corrective surgery.
      10/3/17 CT scan shows no lymph node involvement.

      Comment


      • #4
        Also note "but concerning for neoplastic process. Clinical correlation is warranted"

        Thats the radiologist saying that they believe it could be cancer and needs to be investigated further. IE, removed and biopsied.

        6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
        6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
        7/7/15: bHCG 56, AFP 42, LDH 322
        7/13/15 - 9/18/15: 4xEP
        10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
        10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
        4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
        4/20/16: RPLND @ IU - teratoma only!
        3/29/2018 all clears up to this date!

        Comment


        • #5
          Thanks biwi. I appreciate the help. I'm very happy for you that have all clears. My consult has been moved up to today at 12, so I'm on my way to speak with my doc now.
          9/14/17 Pre I/O markers : AFP 5.8 / HCG <2 / LDH 570
          9/18/17 Chest X-Ray
          9/25/17 Right I/O surgery
          Unifocal Seminoma 5cm. Tumor invades rete testis; Stage T1B
          No evidence of lymphovascular invasion.

          10/2/17 Scrotal hematoma corrective surgery.
          10/3/17 CT scan shows no lymph node involvement.

          Comment

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