Pathology report

[Ski11181]

Mixed germ cell tumor, 3.7 cm. in greatest dimension, 95% seminoma, 5% embryonal carcinoma, surgical margins free of involvement.

spermatic cord lipoma


There is focal intratubular germ cell neoplasia representing aproximately 1% of the lesion. Extension of neoplastic cells to the tunica albuginea or tunica vaginalis is not seen. lymph nodes are not present for evaluation. The pathologic tnm stage of this lesion is best classified as follows pt1, pNX, MX.



So now I have to decide between surveillance or 2 rounds of chemo. Any advice would br appreciated. thanks

[dadmo]

If you were my son I would have you choose the surveillance route, unless there is confirmed distant involvement.

[Fed]

What was said about lymphovascular invasion? Since they say pT1, I am under the assumption that it wasn't present. That being the case, combined with the minuscule amount of embryonal, I would opt for surveillance as long as you are willing to do all of the required follow-ups. Keep in mind that the presence of nonseminomatous elements would force you to follow a nonseminoma surveillance schedule. Check out the NCCN guidelines for details.

[Karen]

What about markers, CT and chest X-ray? That'll fill in the X in "pt1, pNX, MX". The more involved I am in this site the more I lean towards the "hit it early and hard" philosophy. Unfortunately, there are downsides to that as well......
If you do surveillance be VERY dedicated to your follow-up schedule.

[Ski11181]

There was no lymphovascular invasion.

markers were negative.

ct scan was clear.


Even if I did the chemo doesn't pretty much follow the same follow up schedule as surviellance anyway? If that is the case the rigorous schedule of surviellance becomes a mute point. Anybodies thoughts on this?

[dadmo]

Ski11181:
Yes wheather you have chemo, radiation or no active treatment you will still have to do surveillance. I'm with Karen as far as hitting hard and early but in your case it doesn't appear that you have a target to swing at.