Just diagnosed from Pathology.

[JSly07]

Hi all,

My name is Joey I’m 31 y/o from Nebraska. I just recently had a right radical orchiectomy. It’s all been a pretty quick process so far! Yesterday I finally was called back with the Pathology report. All I can remember is her saying, Seminoma mixed cell. She did say the spermatic cord and epididymis came back negative, so she’s hoping it was contained just to the testicle area. My question would be what kind of treatment can be given? I’ve read radiation is sensitive to radiation? If both of those are negative, is it still even possible of it spreading? Sorry for the questions I have my CT scan tomorrow and then the big meeting on Thursday. Hope you’re all doing well, Happy New Year!

[Harxxony]

Hi there, Joey. Seminoma mixed cell is contradictory, as seminoma is sole histological type of TC, and mixed means that there is more than one type. Without full path report and without CT scan there is just not enough information to discuss or to give any useful advice. So we wait until Thursday. Stay strong and positive as you still have 99% chance to live up to 100 yrs.

[Doryman]

As of right now your two options if there is no spread would be surveillance, or one round of chemo. Wishing you the best, and please let us know how everything goes with your oncologist appointment.

[Davepet]

I'd want clarification, on the tumor type as seminoma mixed cell doesn't sound right, I suspect they meant mixed cell, with a high percentage of seminoma. If that is the case, then radiation is not an option. If there is no spread, surveillance will likely be the preferred option with possibly one round of chemo as a second choice. It seems unlikely to me that there will be any spread, but the CT will tell you for sure.

[JSly07]

Hi all! Thanks for reaching out! So yes I worded things wrong. 75% Classic Seminoma and 25% Mixed cell. They did find one small lympho-nodule on my lung? Does that have to do with anything? I guess my Dr isn’t too concerned, but mentioned I’ll have to do some chemo and some radiation. Not sure how much. All preventable measures, so is assume not much. Thanks for the support.

[Harxxony]

Hi Joey. If you got full pathology, blood and CT results please write them, if you want. With just the 75%-25% ratio we can't give you good reply. Single lung nodule as a TC metastasis seems rather odd.

[JSly07]

My Results
Pathology - Mixed Tumor consisting of classical Seminoma 3.0 cm and focal embryo also cell carcinoma 1.2 cm. Very focal lymphovascular invasion.
CT Scan findings: Tiny 3 mm left upper lobe pulmonary nodule representing a small intrapulmonary lymph node.
AFP Tumor Marker = 3.6 ng/mL
hCG-B Tumor Marker = < 2.6

[Harxxony]

Ok, I didnt' get are there two separate masses, one seminoma and other embrional, or is embrional mass inside seminoma mass, but generally it doesn't matter for the purpose of treatment. Mixed TC is considered non-seminoma and treatment is well established. But I'm still confused with normal blood markers that don't corespond with mixed tumor, and this pulmonary node is rather strange as single metastasis, without nodes in rethroperytoneal area that is first landing zone for TC. Maybe other guys can jump into discussion.

[Davepet]

How much experience does your doc have with TC? Radiation isn't used with mixed cell tumors, which are always treated as non-seminoma. Unless there is some indication of spread, surveillance is generally preferred these days. Lung nodules are quite common & without abdominal spread it is unlikely to be TC.

[JSly07]

I apologize guys as I really struggle to understand all of it, and I'm not trying to make my doctor look incompetent. I guess can anyone tell me what "pT2" means for the stage? I guess I'm confused cause I thought my doctor said stage 2, but I mean everything was contained in the testicle, there's no sign of metastasis anywhere, I did have lymphovascular invasion within the testicle. So when I do my own research it looks like Stage 1, not 2. Does anyone know what kind of treatment COULD be done? As I'm being told a little radiation and chemo, so Just wondering, I have my first meeting with my first oncologist next Tuesday, so I'll know more then. Thanks guys!

[Davepet]

pT2 is a further classification of the stage. I expect yours would be "stage1, pTs" afraid I don't recall the codes though, hope someone here can jump in with info.

[Anthony01]

Hi Joey,
See link for the explanation of stages.

https://www.cancer.net/cancer-types/...-cancer/stages

Defintion of pt2 is:
pT2: The tumor is in the testicle, which may include the rete testis, and it has grown into 1 or more of the following parts of the testicle:

• Blood vessels or lymphatic vessels in the testicle
• The epididymis,
• The fatty tissue next to the epididymis called the hilar soft tissue
• The tunica vaginalis

Wish you all the best.