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The "All Clear but Remaing Mass is > 3cm" Thread

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  • The "All Clear but Remaing Mass is > 3cm" Thread

    I wanted to start a thread for those of us who have been given the all clear after treatment, but still have a residual mass greater than 3cm.

    It seems as though there's not a lot of info on these cases, at least from what I can tell. Yes there are a few studies I've read that suggest immediate RPLND for residual mass > 3cm could be careless because a lot of times the mass is necrotic, thus suggesting observation and blood markers to determine next steps.

    If you have a story to tell about your >3cm residual mass, please share, especially if you and your oncologist weighed RPLND or other treatments as an option.

  • dustumor99
    I did 4xEP starting in June 2018, wrapping up in Sept 2018 for a 25cm (10 inches) right retroperitoneal seminoma. The only elevated blood marker was LDH (>1600) with beta HCG and AFP normal, suggesting pure seminoma, and the biopsy only found seminoma as well as a lot of necrotic tissue (biopsy doctor had to take additional samples because he kept getting necrotic specimens).

    After treatment, I did a follow-up PET in October (4 weeks later, a little early for a follow-up scan), where the mass was found to be 7cm in the largest direction. Max SUV was 4.6 in one small region, which is likely inflammation but needs to be monitored, but otherwise, it was an all clear scan and the oncologist labeled it as such.

    So far, there's been no talk about RPLND or radiation or anything else, although I have a follow-up PET scan in a week (Jan 14, 2019). I'm getting my treatment at MD Anderson and will keep this thread updated if anything changes, or if my oncologist suddenly decides to change course on observation.

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