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Seminoma and Spread

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  • Seminoma and Spread

    Good morning gentlemen,

    So I just finished up radiation about 2 weeks ago for 2a classic seminoma. My first CT after my I/O noted one enlarged lymph node to 1.2cm and a small 2mm pulmonary node in the lateral lower left lobe of my lung. They didn't believe the lobe in the lung was related to the cancer, hence the 2a staging. However, they are going to perform another chest CT two weeks from now to ensure it isn't related to the cancer. Assuming that's clear, they'll wait another two months after that to perform another abdominal CT to view the lymph node.

    My concern is any additional spread that could be outside of those areas that will be imaged. I've had some tightness in the back of my right thigh and right calf. And I've been having some headaches lately, so I'm terrified of any spread to the brain. Does anyone have any experience or know how likely spread of seminoma to the leg or brain is? And perhaps what the symptoms of those conditions would be?

    Dr. Einhorn has stated that he doesn't believe my lung nodule is related to the cancer. He also said that if it was seminoma, there is almost no chance that it spreads to the brain. I know I've read a couple stories where it has though. Is it just so unlikely that these individuals are outliers?
    11/16/16 - Something feels off,maybe I have a hernia
    11/23/16 - "You may have cancer"
    12/13/16 - "You most likely have cancer"
    12/21/16 - Left I/O followed by "You definitely have cancer"; 100% classic seminoma, multifocal with tumors at 2cm, 1.2cm, and 4mm, no vascular invasion, no LVI, and no spermatic cord invasion
    12/28/16 - CT scans reveals one suspicious para-aortic lymph node measuring 1.2cm; staged at seminoma IIa
    1/3/17 - Radiation therapy recommended as treatment from hospital tumor board
    1/23/17 - Started RT for 19 sessions
    2/16/17 - All done with radiation
    5/25/17 - All clear given; currently on surveillance

  • #2
    I've never heard of a case spreading to the leg. seminoma spreads very predictably to the retroperitineum first. I'd expect the headaches are more likely to be an after effect from the radiation or even some unrelated factor.

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

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    • #3
      Originally posted by aklesevhsoj View Post
      Dr. Einhorn has stated that he doesn't believe my lung nodule is related to the cancer. He also said that if it was seminoma, there is almost no chance that it spreads to the brain. I know I've read a couple stories where it has though. Is it just so unlikely that these individuals are outliers?
      Leg, definitely not. Hypersensitivity to aches and pains is definitely normal after diagnosis!

      Brain metastasis is rare, they are definitely outliers. Typically TC doesn't reach the Brain until very late stage, IE 3B or 3C. Very unlikely in a 2a staging.
      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!
      5/10/17 all clears up to this date!

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