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  • Question, very nervous

    Hello,

    I'm currently in 2nd line treatment for refractory nonseminoma. Part of the preparation for high dose chemotherapy is a brain MRI. It was routine, and no one ever suspected brain metastases. I never had neurological symptoms. However, when leaving my brain MRI I glanced at the computer and saw white dots on the image of the brain. I went home and compared my memory to images of healthy brain MRI's, and those of multiple brain metastases. Shockingly, my memory of the image looks just like the multiple brain metastasis MRI, with 3-4 small white circles on my image. However, multiple brain metastases would indicate very severe disease, and should produce symptoms if I'm not mistaken. Moreover, my bHCG has been normal for 2 weeks or so, and I really don't see how 3-4 brain tumors couldn't be secreting bCHG when my tumors have always done it.

    Does anyone have experience with brain metastases? Do you think it's possible to have several without symptoms, and with normal tumor markers?

    I could be mistaken, I'm not a radiologist. I could've been looking at some other poor soul's MRI. I'm very anxiously waiting for the results of my scan. It is very puzzling given my normal bHCG level. If these are brain tumors, I guess I'll be sent home without HDCT and have very little time left.
    Turned 22 September 17,2020 Oct 20, 2020 Dx Stage 2c (bulky disease) nonseminoma. 90% teratoma 8% embryonal carcinoma 2% yolk sac. bHCG 154. Right I/O
    Nov 2, 2020. BEPx1. bHCG down to 6.3
    Nov 23, 2020. BEPx2 bHCG <1.2 (normalized)
    Dec 14, 2020. BEPx3. bHCG <1.2 Feb 3, 2021. Markers rising. bCHG 86
    Feb 22, 2021. TIPx1. bHCG down to 1.6
    March 15, 2021. TIPx2. bHCG down to .6
    April 19, 2021. Stem Cell Transplant 1. GemDMC HDCT
    May 25, 2021.Stem Cell Transplant 2. ICE HDCT

  • #2
    Hello, colinjegan.

    It seems to me that brain metastsis are very unlikely in your case, although anything is possible with cancer. Teratoma doesn't spread to the brain, and for embryonal carcinoma and yolk sac to go there, it would indicate it's very advanced stage which it isn't if your body CTs up to now were clean.
    Also, I think it's better to let the experts read the MRI. Those circles may be many things and we lack the knowledge to interpret them properly.
    My advice is don't stress over this until the results are out - it's more likely that everything is fine with your brain.

    It's been a while since your post, are the results ready?
    Pure choriocarcinoma stage 3c - testis primary, mets to lungs, 4 lymph nodes >2 cm
    Left I/O 08/18
    BEPx4 10/18
    round 1 hcg - 225 000, down to 642 then rising
    round 2 hcg - 830, down to 40 then rising
    round 3 hcg - 72, down to 15 then rising
    round 4 hcg - 542, down to 7
    HDC regimen SWENOTECA IV 03/19
    round 1 hcg ~1500, down to 1.14 then rising
    round 2 hcg ~100, down to <0.1
    All clear 06/19. Remission.

    Comment


    • #3
      Hi Axel,

      Yes, the brain MRI came back clear. I was then admitted for my first cycle of high dose chemo. It went as planned, although that made for a difficult and interesting experience! Anyways, I'm at day +28 with bHCG remaining normal, which is a very good sign. I get admitted tomorrow or Thursday for my second cycle; so perhaps I'll make a post after that telling the whole HDCT story.
      Turned 22 September 17,2020 Oct 20, 2020 Dx Stage 2c (bulky disease) nonseminoma. 90% teratoma 8% embryonal carcinoma 2% yolk sac. bHCG 154. Right I/O
      Nov 2, 2020. BEPx1. bHCG down to 6.3
      Nov 23, 2020. BEPx2 bHCG <1.2 (normalized)
      Dec 14, 2020. BEPx3. bHCG <1.2 Feb 3, 2021. Markers rising. bCHG 86
      Feb 22, 2021. TIPx1. bHCG down to 1.6
      March 15, 2021. TIPx2. bHCG down to .6
      April 19, 2021. Stem Cell Transplant 1. GemDMC HDCT
      May 25, 2021.Stem Cell Transplant 2. ICE HDCT

      Comment

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