Reply With QuoteI could be wrong but I thought that pure seminoma would never elevate Hcg. And that if hcg was elevated then it should be treated as a non- seminoma.
Registered User
Apologies for starting a new thread (you can follow previous info at "Pure Chorio Diagnosis")... but figured this was a sufficiently distinct topic.
In any event MSKCC reviewed my slides post I/O and decided that instead of a p1 pure choriocarcinoma (apparently never before diagnosed anywhere)...
I instead have a regular old seminoma (stage p2 -- they found some evidence of lymph invasion). No AFP, high hCG. Estrogen producing.
Seems to make a lot more sense (although I will be sending it out for a 3rd opinion, just in case) but seems crazy to me that a local hospital would feel confident making such an aggressive diagnosis without being extra special sure they were right.
Registered User
I could be wrong but I thought that pure seminoma would never elevate Hcg. And that if hcg was elevated then it should be treated as a non- seminoma.
_____________________
Debrah,
Husband (Cory) age 31..
2/22/12-Consultation for a vasectomy. Turned away and told to get blood work and ultrasound. Cancer suspected.
2/24/12- Dx, B-hcg=9670, LDH=250
2/28/12- L I/O Embryonal, Chorio, teratoma-8.5cm retroperitoneal mass-2.5cm mass in neck lymph node
3/12/12- 4XBEP-Start of Round 1( HCG-8100)
4/2/12 Start of Round 2 (HCG down to 176)
4/23/12 Start of Round 3 (HCG down to 13)
5/14/12 Start of Round 4 (HCG down to 6)
Registered User
Frankly, I, too would be surprised with a stage I choriocarcinoma diagnosis. Pure choriocarcinoma is so aggressive, you usually find a met before the primary.
"Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
11.22.06 -Dx the day before Thanksgiving
12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! Final follow-up: 07/2014.
Please support my fundraising efforts for the 2013 Austin LIVESTRONG Half Marathon!
Registered User
Wow, that's crazy, but great news! I've never heard of seminoma generating the HCG values you had, but that's great that it's not pure chorio. My HCG was only mildly elevated -- just 9.
JPM
JPM
March 2011: Right I/O, Stage IA classic seminoma, 5.0 x 4.5 x 3.5 cm
May 2011: Single-Agent Carboplatin
Currently ALL CLEAR
Registered User
Pure seminoma does not elevate AFP. Seminoma can exhibit elevated HCG markers, though.Originally Posted by Chaps6
JPM
JPM
March 2011: Right I/O, Stage IA classic seminoma, 5.0 x 4.5 x 3.5 cm
May 2011: Single-Agent Carboplatin
Currently ALL CLEAR
Registered User
Seminoma can elevate HCG but the elevation is usually related to tumor burden. My husband had a HUGE tumor in his chest and his HCG was 32.
Heidi
Husband - age 51
10/20/10 - Primary mediastinal seminoma - 10 x 9.3 cm; ß-HCG = 33 (<2.6); AFP = 3.5 (<9); LDH = 274 (100-200 )
11/1/10 4X BEP
12/7/10 End Cycle 2 - ß-HCG = 2; AFP = 4.6; LDH = 139 ; 4XBEP changed to 3 as tumor now 2.1 x 3.7 cm
2/15/11 - Post-chemo PET ; residual 8 mm x 2 cm
6/29/11 - Lung nodules stable or smaller, chest mass continues to shrink & markers all normal
Surveillance since 6/11
Registered User
bhcg is sometimes elevated in seminoma, if the tumor markers do not normalize after the I/O then you treat as a non-seminoma (I believe, someone correct me if I'm wrong)
Anyhow, holy crap, that would be a tremendous relief if that's indeed the case. Crazy to go from a chorio diagnoses to a seminoma diagnoses -- talk about two different ends of the spectrum!
Patrick
28 years old
New York City, NY
Ultrasound on 1/23/12, I/O on 2/1/12
Stage IB
Classical seminoma, 4.5cm, RT invasion, LVI, no spermatic cord margin invasion.
CT scans clear
pre op bHCG: 57, post op: 2.4
On surveillance:
Clear: 5/17/12, 8/23/12
11/29/12 -- CT scan shows 1 enlarged retroperitoneal lymph node 20mmx15mm, stage changed to IIA
12/17/12 - 3/17/13 -- EPx4 @ MSKCC
Clear: 3/7/13, 3/28/13, 5/2/13, more to come...
Registered User
That's why this forum is so great. Thank you for correcting me. I definitely don't want to put false info out there
_____________________
Debrah,
Husband (Cory) age 31..
2/22/12-Consultation for a vasectomy. Turned away and told to get blood work and ultrasound. Cancer suspected.
2/24/12- Dx, B-hcg=9670, LDH=250
2/28/12- L I/O Embryonal, Chorio, teratoma-8.5cm retroperitoneal mass-2.5cm mass in neck lymph node
3/12/12- 4XBEP-Start of Round 1( HCG-8100)
4/2/12 Start of Round 2 (HCG down to 176)
4/23/12 Start of Round 3 (HCG down to 13)
5/14/12 Start of Round 4 (HCG down to 6)
Registered User
I don't want to assault the integrity of other fine hospitals, but MSKCC knows better than anyone. do what they say lol
Registered User
Had a meeting w/Dr. Bosl last week... tumor markers aren't quite normalized yet, so we're going to wait and see... but this seems it could simply be a p1 Seminoma and I may luck out w/surveillance for the time being.
It's incredible to go from one extreme (pure choriocarcinoma) to another in a week -- and my heart goes out to all of you with more difficult diagnoses.
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