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Splenic mass on ultrasound, 2 yrs post chemo

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  • Splenic mass on ultrasound, 2 yrs post chemo


    Hi guys,

    I had my 25 months post chemo exams and all seemed be OK except for a mass (8mm) in my spleen - the ultrasound radiologist thinks its a benign tumor called Splenic haemangioma but even he added a questionmark to the report which scares the **** of me. He recommended another ultrasound later. I haven't talked to my oncologist yet, will do that on 20th Dec.

    I know splenic mets are extremely rare (especially without any mets elsewhere) and my liver, retrop. area, tumor marker and lung X ray were all clear but can't help but thinking about how the hell I have managed to pick up another rare disease / condition on top of TC and fibromyalgia. I hope its indeed just a benign tumor or a a cyst, and not some obscure late teratoma met mimicking a freakin haemangioma. God, im tired of this.

    has anyone had a similar splenic mass earlier or have you heard anything about it in relation to TC survivors?

    (my original tumor was yolk sac + teratoma, had 4 bep and an RPLND. Teratoma worries me a bit in the given contect)

    thanks!




  • #2
    Did they compare to previous imaging?
    6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
    6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
    7/7/15: bHCG 56, AFP 42, LDH 322
    7/13/15: begin 4xEP, end 9/18/15
    10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
    10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
    4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
    4/20/16: RPLND @ IU - teratoma only!
    4/15/19: all clears up to this date!

    Comment


    • #3
      hi Biwi,

      in the previous report (MRI) they noted the spleen's size is at the upper limit - maybe that is related.

      The last abdominal ultrasound was long ago - no mention of this nodule there. So this is the first they mention this but it was not the same radiologist doing the MRI.

      I can see based on your story line that you can relate to my fear of teratoma.

      hope you are all good, mate.

      Comment


      • #4
        Yeah its hard to really say. Comparing it across scans is a good way to see how it is growing. If you were stage 1 or stage 2 originally I would say highly unlikely, but given you had 4xBEP you probably had a decent amount of mets and travel before treatment. So there is a chance it could be something, although I think still fairly low.
        6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
        6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
        7/7/15: bHCG 56, AFP 42, LDH 322
        7/13/15: begin 4xEP, end 9/18/15
        10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
        10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
        4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
        4/20/16: RPLND @ IU - teratoma only!
        4/15/19: all clears up to this date!

        Comment


        • #5
          hi Biwi,

          Well, based on radiology I was stage 2 - my tumor marker moved me into stage 3 (AFP was 6K before the start of the chemo, post op). I had a 5-6 cm lymph met and thats it. not even a lung met.

          I did not want another waiting game, damn it.



          Comment


          • #6
            Splenic metastasis are rare as mentioned but not impossible. Unfortunately, I have no knowledge of comparing imaging of the spleen across modalities to even offer much advice. To me, if they were unsure, then re-imaging seems reasonable but I don't know the best modality to do it (CT, MRI, US, PET) or if keeping the modality the same is more important but I would certainly ask my doctor and perhaps they have gotten some recommendations from radiology on the best approach. Unfortunately, it may be more waiting and its never easy.

            Mike
            Oct. 2005 felt lump but waited over 7 months.
            06.15.06 "You have Cancer"
            06.26.06 Left I/O
            06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
            06.30.06 It's Official - Stage I Seminoma
            Surveillance...
            Founded the Testicular Cancer Society
            6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

            For some reason I do not get notices of private messages on here so please feel free to email me directly at mike@tc-cancer.com if you would like to chat privately so as to avoid any delays.

            Comment


            • #7
              hi Mike,

              the radiologist (who is highly respected by the colleagues and seen thousands of TC patients by now) recommended another ultrasound "later" (in my interpretation during the next check up) and my oncologist was not concerned at all by this incidental finding, the next check up is due in May, abdominal US already scheduled.

              I might want to get an abdominal CT elsewhere (funded privately) in the meantime but maybe its better to check with the same modality later indeed so that the size can be crosschecked........ I dont want to pay for another message going "probably a benign lesion , to be checked later" .. and probably its too early for a biopsy (which is dangerous in the spleen).

              I am somewhat calmer now.





              Comment


              • #8
                hi All, I went for a second opinion to another radiologist who did an abdominal US. He thinks the spot is normal connective issue, not even a hemangioma. sigh...... I am happy now. 2 years passed in December and i am still clear.

                thank you guys.

                all the best for you too.

                Comment


                • #9
                  hi All, I went for a second opinion to another radiologist who did an abdominal US. He thinks the spot is normal connective issue, not even a hemangioma. sigh...... I am happy now. 2 years passed in December and i am still clear.

                  thank you guys.

                  all the best for you too.

                  Comment


                  • #10
                    That’s good news! Odds were against it, and everyone seems to agree that whatever it is it isn’t cancer!
                    3/29/17 Diagnosed 100% Embryonal 4/10/17 Left I/O CT scan shows a few suspicious lymph (biggest 1.9 cm) 5/8/17 - 7/3/17 3xBEP 7/20/17 CT Scan Clear, AFP has uptick to 19 8/16/17 AFP Drops in half to 10, ALL CLEAR! 3/20/19 All clears up to here!

                    Comment

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