Residual Pelvic Mass

[Mick]

My 18 year old son was diagnosed in June with Stage IIC bulky seminoma. He had a burnt out testicular tumor and a 15 cm seminoma mass in his retroperitoneal area. He completed 3x/BEP and went for CT scan on10/6 it revealed a 5 cm residual mass in his pelvic area. We are scheduled for a PET scan to determine if it is viable tumor or necrosis. Can someone please share what is to come if mass is active cancer? Thank you.

[dcalandrelli]

Not a doctor but I’d guess surgical removal. Hopefully someone with more experience can chime in though.

[Mick]

Thanks for your response. Has anyone here had a residual seminoma mass removed sugically (not RPLND)? I understand the chemo turns the tumor into a sticky mess which makes the surgery complicated.

[Trekga]

So sorry to hear. Hopefully someone with Seminoma can answer soon.

[stufax]

My guess is that it's probably dead tissue. I had quite large residual tumors as well. If it's still viable cancer it's probably RPLND next or more chemo (TIP/HDC). RPLND is more complicated but definetly possible. Been there.

[Mike]

Hi Mick,

I am a bit confused. Is this 5 cm pelvic mass new or are you saying it is a pelvic mass from the previous 15 cm retroperitoneal mass? Are his tumor markers normal? How long has it been from the time he ended BEP until the PET scan (typically waiting at least 6 weeks to avoid any false positives is what I have seen recommended).

Mike

[Mick]

Hi Mike- the mass is post chemo -left over from the original 15 cm mass. His tumor markers are normal. His CT scan was about 4 weeks after chemo. He will be getting his PET scan 10/30 about 6 weeks after last BEP.

[Mick]

Hi Stufax- I've been following your posts. So glad to hear you are all clear. Our oncologist said surgery wouldn't be RPLND because the mass is in the pelvic area not a lymph node so it wouldn't be a lymph node dissection. Was your mass in the lymph nodes in retroperitoneal area?

[Mike]

Hi Mike- the mass is post chemo -left over from the original 15 cm mass. His tumor markers are normal. His CT scan was about 4 weeks after chemo. He will be getting his PET scan 10/30 about 6 weeks after last BEP.

If the PET scan is negative then I would assume that they may just watch things. If it is positive, then I am guessing that they would surgically remove the tumor (being a retroperitoneal mass that is in the pelvis makes me wonder if they would do an RPLND+Pelvic lymph node dissection) and if positive for active seminoma face second line chemotherapy. I am not sure where your son is located or being treated but getting the opinion of a testis cancer expert is probably a good idea. Our friends at the TCRC keep a list at: http://tcrc.acor.org/experts.html

I am sure that there is more information out there but for example, the team at Memorial Sloan-Kettering has published on pelvic node dissections at: https://www.ncbi.nlm.nih.gov/pubmed/27235751

Mike