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Pure Classic Seminoma

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  • Pure Classic Seminoma

    Hi everyone,

    I’m back and I thought I would post my pre-orchiectomy blood test and pathology report:

    4-16-19 Blood Test:

    LDH 286 Ref Range: 100-220 U/L (HIGH)
    AFP 3.6 Ref Range: <6.1 ng/mL
    HCG <2 Ref Range: <5mIU/mL

    4-29-19 Orchiectomy Pathology Report:

    Histologic Type: Pure Classic Seminoma
    Dimensions: 3.0 x 2.8 x 2.5 CM
    Tumor Focality: Focal
    Intra-Tubular Germ Cell Neoplasia (ITGCN): Present
    Scattered Syncytiotrophoblastic Giant Cells: Absent
    Rete Testis Involvement by Invasive Tumor: Absent
    Extension Beyond Tunica Albuginea: Absent
    Angiolymphatic Invasion: Absent
    Spermatic Cord Margin: Negative
    Necrosis: Absent
    Serum Tumor Markers: Not available
    pT1NxMxSx (AJCC 2010, 7th Edition)

    The Gross Description was quite lengthy, but in short it mentioned the presence of a second mass which measured 1.5 x 1.5 x 1.0 cm. The description also noted that neither mass appears to involve the rete testis or epididymis, however the epididymis had a 0.3 cm smooth walled cyst on its surface.

    Last week I had my CT scans and I will go back this week for my follow-up blood test. In the mean time I have a few questions:

    If my CT scans show all clear, I understand the size of the tumor is an indicator for potential risk of relapse, but how does the presence of the second tumor increase this risk?

    It seems the pathology report didn’t specify if I am pT1a or pT1b; it seems that with a 3cm tumor I would be pT1b (per How would this affect potential relapse risk?

    Lastly, does anyone know of any statistics that can point to a tumor size corresponding to a specific rate of relapse? I have read that 4cm is considered a reliable risk factor, but I’m curious if there is any way to better predict my own chance for relapse.

    Thanks for reading and any insights. When I have a meeting with an Oncologist I will also ask these questions of him or her, but for now I want to gather as much information as I can.