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  • Periaortic Adenopathy

    Hey guys. Been lurking around here for a year, finally created a profile to ask a question.

    I’m 27. Had my orchiectomy in early May 2018. Pathology was left testicle seminoma. Multi focal 3.3 and 2.1 cm in greatest dimension. Tumor invades rete testis but no LVI. Stage mpT1b NX. Pre surgery serum markers were within normal limits.

    Been doing pelvis/abdomen mri’s, bloodwork and chest X-rays every four months since then. Friday was my 12 month scans (last time I ever schedule an mri for a Friday). The doctors head nurse called me Friday afternoon and told me before she released the results to my mychart she wanted to give me a heads up that there was something on there and that the doctor is aware and would be discussing with me Wednesday (tomorrow) at my regular post scans appointment. Bloodwork was normal. But new enlarged 12mm short axis periaortic lymph node (prior mri with 5mm).

    The impression was “new 12mm periaortic adenopathy in this context worrisome for metastatic disease.”

    So I’ve been getting more and more anxious each day since Friday to find out what the doc will say. Anyone have any idea what I should expect or be prepared for tomorrow?

    Thanks.

  • #2
    Not trying to be smart, but my guess is that doc will say one of two things: a) order PET CT immediately, or b) order another MRI in 3-5 weeks. 12 mm node is slightly enlarged and it doesn't mean that it is metastatic disease, but enlargement from 5 to 12 mm is worrisome. I believe that 12 mm node is to small for biopsy. Hold on.
    45yo, left I/O 07/30/2018, T1 pure seminoma, surveillance...
    Waiting...

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    • #3
      Originally posted by Harxxony View Post
      Not trying to be smart, but my guess is that doc will say one of two things: a) order PET CT immediately, or b) order another MRI in 3-5 weeks. 12 mm node is slightly enlarged and it doesn't mean that it is metastatic disease, but enlargement from 5 to 12 mm is worrisome. I believe that 12 mm node is to small for biopsy. Hold on.
      I agree. Think PET or further watching is most likely. Highly doubt they’ll biopsy something that size.

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      • #4
        For most types of TC, 1 cm is the trigger point for further treatment, I seem to recall that for seminoma, it is 2cm, can anyone verify that?
        Jan, 1975: Right I/O, followed by RPLND
        Dec, 2009: Left I/O, followed by 3xBEP

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        • #5
          Davepet, I believe you are correct. The Doc said he wasn't overly concerned, that it could be something else (maybe colonic), but PET CT and the normal MRIs in 6-8 weeks to see if it's grown. If it has he said laparoscopic RPLND is his preferred treatment (especially with Seminoma). I have the Bar exam July 30 - August 1 so we scheduled the PET CT for August 5. Hoping its something else but expecting it to grow.

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