Confirmed mass today....orch. tomorrow.

[Scott]

Glad to hear the good news, Bobby! Keep us posted.

[fuse929]

Hey All,
This is my report: Lobulated and poorly defined 1.6x1cm subcapsular mass approaching but not involving the head of the epididymis. Histologic sections show testicular tissue showing some atrophy and a multifocal neoplasm composed of sheets and groups of gonadoblasts showing central nuclei, prominent occasionally multiple nucleoli and ample clear pale eosinophilic cytoplasm. Mitoses are present but are infrequent. There is an associated lymphocytic host immune response and infiltrate. No evidence of hemorrhage or necrosis within the tumor. A PAS stain, and a properly controlled panel of immunohistochemical stains were performed with the following results: PAS stain shows strong staining of glycogen in the tumor cells, characteristic of seminoma. CD-117 and PLAP are positive in neoplastic cells. NSE is strongly positive. Vitmentin, CD30 and EMA are essentially negative in tumor cells. The histology and staining pattern are consistent with seminoma. There is no involvement of the testicular capsule, rete testis or epididymus: tumor appears to be confined to testicular parenchyma proper.

Diagnoses: Multifocal intratesticular seminoma, left testicle.

Chest, Abdomen and Pelvis are normal (CT). Blood pre and post I/O is normal.

My uro told me this was the earliest he has personally ever seen TC caught, and because of this and the above diagnosis, offered me either surveillance with a CT and Chest x-ray every 2 months for the first year, or a small amount of radiation. I asked what he would do if he was in my shoes, and after about 2 min of quiet thinking he told me he would go with surveillance. I believe I'm going to chose surveillance, and believe me, I will be vigilant with it.

How important do you all think it is to get second opinions? Also, in your opinions and with your experiences, is surveillance an appropriate choice?

Thank you all.......things are looking really good,

Bobby

[Fed]

things are looking really good

Indeed they are. You have pretty much the same diagnosis I had: multifocal seminoma (with the difference that mine was in righty).

Second opinions are very helpful when you don't feel comfortable with the assessment of your doctor. I got a second read on the pathology because the first doctors I saw were very dismissive of my concerns, and they raised more questions than provided answers. It certainly doesn't hurt to have one done (my insurance covered it, so in my case, it was a no-brainer).

Surveillance is a perfectly good choice for your diagnosis. As long as you follow the protocol to the "T" and can handle the anxiety that comes along with every approaching check-up date, you will be fine with this form of treatment. I am surprised, though, that your doc is recommending CTs every 2 months. That's twice the recommended protocol, and CTs do give you a pretty large dose of radiation (certainly not nearly as much as adjuvant radiation, but considerably more than the average chest X-ray). The most common protocol for stage I seminoma is CT and markers every 4 months and chest X-ray every 8 months for years 1-3. Then CT and markers every 6 months and chest X-ray once a year for years 4-7. Finally, once a year thereafter. Details on this can be found at http://tcrc.acor.org/.

Things are good, indeed.

[djmac]

For the record. I'm getting every 3-4 months, and I'm getting the CXR done every time. My uro insisted on it, oh, and tumor markers...

djm