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  • please waiting for your help ..

    My son was diagnosed intratubular germ cell neoplasia. He has %45 embriyonal carcinoma, %5 yolk sac and %50 teratoma. His tumor size was 6,5x5x5. Lymphovascular invasions. And the size of lymph node is 2.1x 1.3 cm. His afp level was 119, bhcg was 244 and ldh was 446 before operation. after afp came down to 37, bhcg 179 and ldh 172. Doctor decided 3 cycles of BEP. He is having his last cycle at the moment and his afp is 1.91 bhcg is 0.3 and ldh is 171 . As we are reaching end of chemotherapy, doctors are talking about RPNLD for my son. I kindly ask your idea about the situation . Because oncologist says whatever the situation is he definitely will have RPNLD surgery. Even if the lymph nodes go back to normal does he still need RPNLD? Thank you so much .

    Kind regards

  • #2
    Hi omerkulum,

    Sorry to find you here. Your son’s pathology is similar to my son, my son is 50%EC, 30% teratoma,20% YSC. My son relapsed during his fourth month surveillance , he started his BEPx3, end up on 2th January 2019, CT on February showed one enlarged lymph node in abdomen, he had RPLND on 14th March , one node with teratoma was found and no further treatment needed.

    I want to tell you after BEPx3, about 30% TC patients end up with RPLND, especially the primary tumor contains teratoma. In this Form, you can find very offen, people with teratoma treated with RPLND after chemo. But I never saw patient after chemo without enlarged lymph node more than 1cm needs RPLND.

    I suggest you discuss with your son’s oncologist, if he/she can’t make you clear, perhaps email Dr. Einhorn, listen to him would be the best.

    Best wishes to you and your son.

    Amy,Ran’s mom
    Son Ran, 24 years old, 25th May 2018 diagnosed NSGCT. 28th May 2018 right orchiectomy. Pathology:50% EC, 30% Teratoma,20% Yolk sac. CTs: 1 retroperitoneal lymph node 0.7mm Tumor markers: AFP 497, bhcg 19, LDH normal Normalized after R/O. Stage 1, surveillance 17th September 2018, Bhcg elevated up to 5.6 AFP and LDH normal, CT stable. 4th November bhcg up to 28, AFP and LDH normal. BEPx3 started and 2nd January 2019 BEP finished with Tumor markers normalized. 13th February 2019 CT scan showed 1 retroperitoneal lymph node enlarged up to 1.1 cm with normal tumor markers. RPLND : 03/14 2019@IU Dr.Cary Pathology report: one lymph node from 57 is Teretoma .Back to surveillance 05/02/19 Blood work all normal

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    • #3
      I had some Teratoma in my pathology and ended up having one slightly enlarged node at 1.4 cm. After 3x BEP it shrunk under 1 CM so I did not have a post chemo RPLND. I finished chemo August 2017 and have been all clear ever since. Hope everything goes well! He will get through it!

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      • #4
        Thank you to allyou.you can write axample like this.what do you think our rate of getting rid of out disease is

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        • #5
          First, get the post chemo CT scan done. If there are no large nodes, there is no need for RPLND. If there are nodes >1 cm, than the RPLND is advised.If there is any doubt, email Doc E.

          The cure rate for most cases of TC is in the high 90% range.

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

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          • #6
            thanks Dave

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