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Interesting find: rplnd, and teratoma after chemo

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  • Interesting find: rplnd, and teratoma after chemo

    Hello. I was really curious about this.

    Just came back from the oncologist. In my situation, I was diagnosed with Stage 1-S non-seminoma, which was made up of embryonal and yolk sac. No teratoma was found.

    I asked my oncologist about the possibility of having an RPLND after the chemotherapy treatment. She mentioned to me that it was only determined if my lymph nodes were enlarged in the next CT scan. Based on the first ct scan results before treatment, my lymph nodes were normal, and there was no spread found (hence, stage 1-S)

    She did mention to me, however, about the possibility that chemotherapy could actually make some non-seminoma type tumors into teratoma, the reason for the RPLND. I was shocked by this news. And I have heard of teratoma being found, when teratoma was not diagnosed in the first biopsy.

    Just wondering if anyone else has heard of this before. It's news to me, but I could believe it to be true. And this frightens me more than anything about the possibility that I suddenly have teratoma after all this madness. Insights please.
    Diagnosed March 8th 2010 (my mother's birthday :\)
    Left I/O March 9th 2010
    AFP: 17, other markers: Normal, CT Scan: Clear.
    Stage 1-S Non-seminoma: 80% Embyonal, 20% Yolk Sac
    4xEP: April 19th - July 2nd
    August 20th 2010: AFP: 5.5, all markers: Normal. CT Scan: Scheduled.

    All Clear.

  • #2
    I've not heard of chemo changing things into teratoma, but that's just me. If teratoma appears later, I think it was probably missed in the original path report.

    If you want some peace of mind, you might want to have your orchiectomy slides sent to IU for a second opinion on the pathology.
    Vinny (aka Frank)
    http://vinnysgotcancer.blogspot.com

    left I/O 1/5/05; 95%EC / 5% mature teratoma; stage IIIC
    4x BEP 1/24/05 - 4/11/05; RPLND (left side) 5/31/05
    VATS resection of teratoma from left lung 4/26/06
    Presently surveilling

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    • #3
      Originally posted by Lithium View Post
      Hello. I was really curious about this.
      She did mention to me, however, about the possibility that chemotherapy could actually make some non-seminoma type tumors into teratoma, the reason for the RPLND. I was shocked by this news. And I have heard of teratoma being found, when teratoma was not diagnosed in the first biopsy.
      I haven't heard of that either. I'm wondering if she meant that after you do chemo it's possible that deposits of teratoma could be detected, since chemo does not kill teratoma. If teratoma wasn't found in you're pathology, I wouldn't be concerned with it. One less thing to worry about, ya know?

      Hope that helps.
      5/4/2010 - Diagnosed with TC
      5/20/2010 - Right I/O - 1.8cm - no LVI - 70% Seminoma - 30% EC - Less than 1% Teratoma - Stage 1A
      6/7/2010 - RPLND Scheduled. Oncologist requested for second opinion.
      6/15/2010 - Oncologist seen and Chemo not an option for stage 1A.
      7/6/2010 - Right sided template RPLND - Surgeon Dr. Stephenson(Huntsman Cancer Center)
      7/12/2010 - Pathology clean on surveillance.
      11/11/2010 - Clean

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      • #4
        Actually, it does happen, and yolk sac is the most typical tumor type to do so. My husband was 100% pure yolk sac at diagnosis, and after his RPLND, teratoma was also found.
        Husband diagnosed March 1st, 2009 * Stage III * Yolk-Sac * Mets in Abd, liver, and lung * 4XBEP 3/09-5/09 * HDC 07/09-08/09* HDC Fail 9/09 * PET Scan shows tumor isolated in abdomen * RPLND 9/09 * Remission 10/09 * Oral Etoposide * Relapse 1/10 * Gemzar/Taxol started 2/8/10 * Failed 4/10* ARQ197 Clinical trial 04/10 * Fail * Next Clinical Trial 7/10. Brain tumors=trial cancelled. Whole Brn rad. 7/10. Seizures. Salmonella 8/10. Cyberknife 9/10. Mouth tumors diag. 11/10. Passed away 1/11/11

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        • #5
          And it doesn't necessarily have to be due to chemotherapy. Teratoma is the "endpoint" in the development of germ cell tumors.
          "Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
          11.22.06 -Dx the day before Thanksgiving
          12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! I consider myself cured.

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          • #6
            Please find attached some quotes from a paper:


            ...Of the 111 patients operated on, 67 (60.4%) had a mature teratoma component in
            the primary tumor. This mature teratoma component was also present in the
            retroperitoneal residual tumor mass in 42 out of these 67 patients (63%), as well
            as in the residual tumor in 11 out of the 44 patients (25%) who did not have
            mature teratoma in the primary tumor....
            ...The prognosis after the resection of residual disease is generally favourable, with
            a 5-year recurrence-free survival of over 85% after resection of necrosis or
            mature teratoma and of between 50% and 80% after the resection of viable cancer
            followed by additional chemotherapy...
            Source: http://dissertations.ub.rug.nl/FILES....e.gels/c5.pdf
            Diagnosed September 2009:
            Right orchiectomy
            95% embryonal carcinoma, 4% mature teratoma, 1% yolk sac
            CS2B: Beta HCG: 306, One enlarged Lymphnode (interaortocaval) 3,2x2,9cm. Good prognosis.

            3x BEP, Beta HCG < 0,6, Residual Mass = One enlarged Lymphnode around 0,6x0,7cm, Bilateral L-RPLND: 28 nodes removed - 27 clear, 1 mature teratoma (the enlarged one)

            All clear so far!

            Sorry for my bad english

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