Hello everyone,
My name’s Chris and I’m writing from NY (as my username no doubt reveals). I’m an active, healthy (besides the obvious) 34-year-old.
I’d first like to thank you all for the community you’ve created on here. I’ve been lurking the past few weeks, and it’s been both informative and encouraging to see all the support you offer each other. Indeed, it’s kept me sane during this difficult period in my life, which I’d like to share with you:
After finding a small lump on my right testicle in mid-December, doctor visits and tests brought me to a Right I/O on February 9. The surgery went well and I’m recovering just fine. Met with my urologist (who performed the surgery) yesterday to review the pathology report (sorry for its length, but figured I’d include everything):
Microscopic Diagnosis:
RIGHT TESTES AND SPERMATIC CORD, ORCHIECTOMOY:
Germ cell tumor/embryonal carcinoma, measuring 0.8 x 0.8 x 0.7 (see synoptic report).
Testicular atrophy is present adjacent to embryonal carcinoma.
Spermatic cord lipoma.
Immunohistochemistry:
CD30: Positive in tumor cells.
OCT3/4: Pending, will be reported in an addendum.
PLAP: Positive in tumor cells.
AE1/AE3: Focal weak staining in tumor cells.
SYNOPTIC REPORT: GERM CELL OR SEX CORD-STROMAL TUMOR OF THE TESTIS
Specimen laterality: Right.
Tumor focality: Unifocal.
Tumor size: 0.8 x 0.8 x 0.7 cm (gross measurement).
Histologic type: Embryonal carcinoma
Tumor extension: Tumor limited to testis.
Margins
Spermatic cord margin: Uninvolved by carcinoma.
Other margin(s): Uninvolved by carcinoma, tunica vaginalis.
Lymphatic-vascular invasion: Present.
Regional Lymph Nodes: Not submitted.
Histologic subtype of germ cell tumor in involved lymph nodes: N/A.
Additional findings: Germ cell neoplasm in situ.
AJCC pathologic staging: pT2 pNX
Pre-orchiectomy serum tumor markers (performed on 01/19/2021):
Serum marker studies: within normal limits.
Serum tumor markers: S0
Gross Description:
“Right testis and spermatic cord.” A 37 g, 3.5 x 2.5 x 2.2 cm intact testis with a 3.5 x 0.9 x 0.4 cm attached epididymis and a 8.1 x 1.0 cm attached spermatic cord. The tunica vaginalis is intact, inked. Tissue is bivalve to show gray-white, smooth, glistening, intact tunica albuginea. Sectioning shows a 0.8 x 0.8 x 0.7 cm tan-brown, focally soft, well delineated lesion which is within .1 cm of the tunica of the albuginea and tail of epididymis, is within 10.5 cm of the spermatic cord margin. Remaining testis shows orange soft seminiferous tubules that can easily be teased. Additionally at the proximal margin is a 2.8 x 1.4 x 1.2 cm fatty, intact portion of adipose tissue attached to the spermatic cord. Cut surface is yellow, homogenous. RS as follows:
1. proximal spermatic cord margin
2. mid spermatic cord, adipose tissue
3. distal spermatic cord
4-6. lesion in its entirety, adjacent normal parenchyma, tunica albuginea, tunica vaginalis, possible rete testis, tail of epididymis
7. additional normal parenchyma, epididymis lms
I’m trying to be optimistic about all the encouraging signs: I have no symptoms, my blood results are normal, the tumor was small (even smaller than the ultrasound suggested), there was no spermatic cord involvement, and my Dr said the tumor was confined to the membrane surrounding the testicle itself (it apparently didn’t penetrate inward).
But I’m also concerned with the cell type of 100% embryonal carcinoma (apparently rare and aggressive) and the presence of LVI.
I’d of course welcome any comments, but I have two questions I’m particularly interested in:
1. My Dr sort of downplayed the presence of LVI, saying he sees that practically every time. Based on my research, however, LVI is often enough negative, even in 100% EC, and it’s definitely a better sign to not have it.
2. The pathologist staged me at pT2 pNX, which confused both me and my Dr. He said he checked with two of his colleagues, re-checked the official staging guidelines, and they all said there was nothing on my pathology report to support the Stage 2 identification (and apparently the pathologist will be unavailable to clarify until next week). What instead will show my exact stage is the results of the CT scan, which I hope to have next week. Maybe the pathologist noted the 100% EC and LVI and simply had to provide her own guess about spread?
Thank you in advance for any insights you can offer and I wish you all a great weekend.
Best,
Chris
My name’s Chris and I’m writing from NY (as my username no doubt reveals). I’m an active, healthy (besides the obvious) 34-year-old.
I’d first like to thank you all for the community you’ve created on here. I’ve been lurking the past few weeks, and it’s been both informative and encouraging to see all the support you offer each other. Indeed, it’s kept me sane during this difficult period in my life, which I’d like to share with you:
After finding a small lump on my right testicle in mid-December, doctor visits and tests brought me to a Right I/O on February 9. The surgery went well and I’m recovering just fine. Met with my urologist (who performed the surgery) yesterday to review the pathology report (sorry for its length, but figured I’d include everything):
Microscopic Diagnosis:
RIGHT TESTES AND SPERMATIC CORD, ORCHIECTOMOY:
Germ cell tumor/embryonal carcinoma, measuring 0.8 x 0.8 x 0.7 (see synoptic report).
Testicular atrophy is present adjacent to embryonal carcinoma.
Spermatic cord lipoma.
Immunohistochemistry:
CD30: Positive in tumor cells.
OCT3/4: Pending, will be reported in an addendum.
PLAP: Positive in tumor cells.
AE1/AE3: Focal weak staining in tumor cells.
SYNOPTIC REPORT: GERM CELL OR SEX CORD-STROMAL TUMOR OF THE TESTIS
Specimen laterality: Right.
Tumor focality: Unifocal.
Tumor size: 0.8 x 0.8 x 0.7 cm (gross measurement).
Histologic type: Embryonal carcinoma
Tumor extension: Tumor limited to testis.
Margins
Spermatic cord margin: Uninvolved by carcinoma.
Other margin(s): Uninvolved by carcinoma, tunica vaginalis.
Lymphatic-vascular invasion: Present.
Regional Lymph Nodes: Not submitted.
Histologic subtype of germ cell tumor in involved lymph nodes: N/A.
Additional findings: Germ cell neoplasm in situ.
AJCC pathologic staging: pT2 pNX
Pre-orchiectomy serum tumor markers (performed on 01/19/2021):
Serum marker studies: within normal limits.
Serum tumor markers: S0
Gross Description:
“Right testis and spermatic cord.” A 37 g, 3.5 x 2.5 x 2.2 cm intact testis with a 3.5 x 0.9 x 0.4 cm attached epididymis and a 8.1 x 1.0 cm attached spermatic cord. The tunica vaginalis is intact, inked. Tissue is bivalve to show gray-white, smooth, glistening, intact tunica albuginea. Sectioning shows a 0.8 x 0.8 x 0.7 cm tan-brown, focally soft, well delineated lesion which is within .1 cm of the tunica of the albuginea and tail of epididymis, is within 10.5 cm of the spermatic cord margin. Remaining testis shows orange soft seminiferous tubules that can easily be teased. Additionally at the proximal margin is a 2.8 x 1.4 x 1.2 cm fatty, intact portion of adipose tissue attached to the spermatic cord. Cut surface is yellow, homogenous. RS as follows:
1. proximal spermatic cord margin
2. mid spermatic cord, adipose tissue
3. distal spermatic cord
4-6. lesion in its entirety, adjacent normal parenchyma, tunica albuginea, tunica vaginalis, possible rete testis, tail of epididymis
7. additional normal parenchyma, epididymis lms
I’m trying to be optimistic about all the encouraging signs: I have no symptoms, my blood results are normal, the tumor was small (even smaller than the ultrasound suggested), there was no spermatic cord involvement, and my Dr said the tumor was confined to the membrane surrounding the testicle itself (it apparently didn’t penetrate inward).
But I’m also concerned with the cell type of 100% embryonal carcinoma (apparently rare and aggressive) and the presence of LVI.
I’d of course welcome any comments, but I have two questions I’m particularly interested in:
1. My Dr sort of downplayed the presence of LVI, saying he sees that practically every time. Based on my research, however, LVI is often enough negative, even in 100% EC, and it’s definitely a better sign to not have it.
2. The pathologist staged me at pT2 pNX, which confused both me and my Dr. He said he checked with two of his colleagues, re-checked the official staging guidelines, and they all said there was nothing on my pathology report to support the Stage 2 identification (and apparently the pathologist will be unavailable to clarify until next week). What instead will show my exact stage is the results of the CT scan, which I hope to have next week. Maybe the pathologist noted the 100% EC and LVI and simply had to provide her own guess about spread?
Thank you in advance for any insights you can offer and I wish you all a great weekend.
Best,
Chris
Comment