Sertoli leydig cell tumor

[Porkymail]

Hi guys , I just got my pathology report it said I have Sertoli-lydig tumor type ( prefer Sertoli)
The tumor size is 0.8 * 1.0 cm, 10 days ago I had testis sparring surgery since my doctor prefer that way. Now he said I'm most likely OK and put me on observation since this type tumor is 90% benign and my tumor was small.
After research and read posts here, I have some worries. Since the malignant version of Sertoli-lydig is very bad, should I ask for a CT scan now to double check ? And is there any other test to diagnose if it's benign or malignant?
Thanks a lot

[sanis]

hello Porkymail,

it is very likely that you are cured but I would definitely ask / push for the CT. The size of the tumor is not always a strong indicator and 90% benignity also means 10% malignity. You could always check your state's protocol that is valid for this tumor - i am almost sure that will also mention a CT - at least my country is conservative in this regard...

no need to panic but the CT will bring you the piece of mind you need.

[sanis]

*peace not piece..

[Porkymail]

Thank you so much. I can't find any related protocol regards to this type of tumor in my country unfortunately. I will try to get a CT scan with another doctor. Meanwhile, Here is some data on my pathology report, anyone here can read this?
CK(pan)(+), Vimentin(partial+),S-100(+, minor),Ki-67(2%),CD99(partial+),Calretinin(CR)(-),SMA(-),CK7(partial+),PLAP(-),Inhibin A(-)

[sanis]

Unfortunately I cant. Where are you from?

[sanis]

Even wiki is mentioning repeated imaging for this tumor, see below (i am sure you have read it by now).
Rare tumor, just like mine, man! (i had a paratesticular yolk sac with some teratoma).

The usual treatment is surgery. The surgery usually is a fertility-sparing unilateral salpingo-oophorectomy. For malignant tumours, the surgery may be radical and usually is followed by adjuvant chemotherapy, sometimes by radiation therapy. In all cases, initial treatment is followed by surveillance. Because in many cases Sertoli–Leydig cell tumour does not produce elevated tumour markers,^[7] the focus of surveillance is on repeated physical examination and imaging. Given that many cases of Sertoli–Leydig cell tumor of the ovary are hereditary, referral to a clinical genetics service should be considered.
The prognosis is generally good as the tumour tends to grow slowly and usually is benign: 25% are malignant.^{[citation needed]}

[Porkymail]

Thanks sanis, I'm from China. I got a enhanced (with iodine) pelvic and abdomen CT scan today and will get result tomorrow.
I also emailed Dr. Einhorn and so glad get his reply:
"If there is no hemorrhage or mitoses, this then has a very low probability of metastasis. However, if we were seeing you we would do an abdominal CT scan always at baseline to make ertain there are no enlarged lymph nodes and then repeat every 6 months year 1 and annually years 3-5 together with a history and physical exam. No need for any blood tests."

[sanis]

Hi there.

Good news, and also you were quick. i am surprised your first doctor did not consider it necessary but at least you could find a better one...

[MamaAng]

Dr. Einhorn's advice is MONEY.... hoping for continued good news!!!

[hinear]

You should do CT scan to know whether it has spreaded out. Good to know Dr Einhorn give you the most professional advice.

[Porkymail]

Hi guys, I just got the result of CT scan and its all clear I'm so happy and feel lucky about and thanks everyone for advices! Now I will be on surveillance and hope all good !

[Porkymail]

Some extra story here: Before my testis-sparing surgery I have a painless small hard lump at the bottom of my left testicle (actually that was the reason I went to see doctor). I had 2 ultrasound scans but both of them just mentioned the tumor inside, not the hard lump at bottom. Neither my urologist. Now it's 2 weeks after surgery and my left testicle get back to normal, but the lump is still there. Do you guys think it can be something else ?

[sanis]

Hi there,
is it a lump on your testis or on your epididymis?
if it is indeed a HARD lump, I think you should go for an ultrasound. quick and easy.
Normally testicular cancer happens within or on the testicle, while your type of tumor is usually closer to the epididymis and cord (same happened with me). this is why i would be cautious if it is a hard one.

[sanis]

but most probably they must have seen it if it was cancerous... but better to doublecheck with them if you are worried and it was not there until now. (i mean pre-surgery..)

[Trekga]

I would follow Dr. E's suggestion.