2.3cm lung nodule after 9 years post chemo, need help navigating next steps

[shorty]

My husband was diagnosed stage IIIC in 8/2008, Left I/O (100% Embryonal Carcinoma per pathology report), HCG 27, metastasis to the para-aortic lymph nodes measuring 8.5cmx1.9cm (nothing seen in the lung), 4xEP, several blood transfusions during treatment.
Finished EP rounds 12/2008, CT scan showed 7mm nodule in right lower lobe of lung, another followup CT 3/2009 was negative and showed the nodule had resolved.
5 years of followup care and given the all clear after 5 years that no surveillance was needed.

Fast forward to now. Husband was just in ER with kidney stones. abdominal CT showed a 2.3cm nodule at the right lung base posteriorly and medially. They were concerned about pulmonary metastasis as this is the same location as the 7mm nodule from 12/2008 that was thought to be resolved. We had an appointment with a pulmonary specialist this week. She ordered a PET/CT scan and I requested they pull tumor markers although they were never very elevated in the first place.

We are waiting for the results of his PET/CT scan and blood work. We did get an image CD and I have looked at it. Nothing seems to have an alarming amount of uptake but I could spot the nodule easily at the base of the lung.

I'm wondering what the odds are that this could be teratoma that was left behind after treatment that is now growing although his pathology was 100% embryonal carcinoma I would imagine that teratoma would still be possible? And, is there anything else we need to be requesting to help him find a diagnosis and determine what this nodule is?
His pulmonary specialist said they would likely biopsy the nodule regardless if there was uptake in the PET/CT scan or not. Is this the right step moving forward?

Thank you in advance for any guidance you can give.

[Mike]

I would be interested in getting the tumor makers as well. Regardless if it is teratoma, embroynal or something different, I think after 9 years the key would be to get a tissue diagnosis to know for sure what you are dealing with. I am assuming that is why the pulmonologist said that she will likely do a biopsy regardless of the PET results. With the tissue diagnosis, if it is TC related, you will have a better idea if you are looking at the ned for surgical resection vs. more chemotherapy.

I know how scary it can be, especially when just waiting for more information and answers, so I hope you get some soon. Please keep us posted.

Mike

[Trekga]

So sorry to hear that after 9 years something is visualized at same place on lung- an area that was thought to have resolved. i think running the tumor markers is a start, and I concur with Mike that the Pulmonologist is making a good call doing the biopsy. Again, sorry to hear.