Pure embryonal to teratoma? Questions

[dcalandrelli]

Met with my oncologist today and he said the post chemo scan we will do really with be looking for cysts and teratomas. My original diagnosis was 100% EC. He wasn't concerned about embryonal still being around after 3xBEP. I've read that without chemo embryonal over time can turn into teratoma, but how common is it to have teratoma in the lymph with original diagnosis of 100% EC. I've personally only read about teratomas showing up without them being part of the original diagnosis in late stage or with mixed cell. Is it uncommon to develop teratoma with 100% embryonal being treated fairly early?

[jpboucher]

Hey,

From what I read and searched last year on this, it seems to happen in 7 - 10 % according to two cohort data, one in Toronto, Canada, and the other one in NYC, USA.

I have started a post on this forum, where you can find the references. Here's the link

http://www.tc-cancer.com/forum/forum/during-treatment-and-beyond/treatment-after-the-orchiectomy-radiation-chemotherapy-rplnd-surveillance/286265-pure-embryonal-carcinoma/page2

Hope that helps,

jp

[dcalandrelli]

Thank you this is very helpful! It seems unlikely my EC would transform since I jumped on chemo early, but still a possibility I should be aware of. Odds seem in my favor! I appreciate all your effort on your research!

[Davepet]

I am no doctor, nor am I an expert, but since teratoma is defined as "normal cells growing in abnormal places" by the Testicular Cancer Resource Center Dictionary, I suspect that the cases attributed to "transformation" of EC to teratoma are actually cases where teratoma was already present, but not detected.If it is indeed possible for a cancer cell to transform into a normal cell in the wrong place, I have seen no studies showing how that might happen. I suspect we need better infomation on this topic.

Dave

[biwi]

I am no doctor, nor am I an expert, but since teratoma is defined as "normal cells growing in abnormal places" by the Testicular Cancer Resource Center Dictionary, I suspect that the cases attributed to "transformation" of EC to teratoma are actually cases where teratoma was already present, but not detected.If it is indeed possible for a cancer cell to transform into a normal cell in the wrong place, I have seen no studies showing how that might happen. I suspect we need better infomation on this topic.

Dave

I think it seems reasonable though, given how typically it happens in lymph nodes already involved with EC, such as in my case. Based on the terratoma growth rate I had, it would be one heck of a coincinence if I had a small teratoma at birth that just happened to grow in my lymph node only when I had EC TC.

[dcalandrelli]

I wonder if it follows a hierarchy of transforming from EC, to yolk, to teratoma. I've noticed teratomas pop up more in mixed cells than pure cells. Not an expert at all just a trend I've noticed. Timing also seems to be a factor. I've noticed teratomas seem to pop up when it's caught later or during relapses when it's had more time to possibly transform.

[Mike]

Germ cell tumors are tumors of differentiation meaning that less specialized cells have the ability to become more specialized cells. As far as teratoma it basically arrises out of differentiation of embryonal cells and to an extent yolk sac cells to teratoma. I have attached a nice image from a presentation Dr. Bosl gave at the American Society of Clinical Oncology in 2016 to help show what I am saying.

Mike

[dcalandrelli]

Interesting thank you very much! Hopefully we started my chemo early enough that it didn't get the chance to transform and I avoid additional surgery!