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Potential Teratoma in Non-Seminoma and Dr. Daneshmand in Los Angeles

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  • Potential Teratoma in Non-Seminoma and Dr. Daneshmand in Los Angeles

    My son has just finished 3XBEP. Stage IIB Non-seminoma (without teratoma in the primary tumor). CT-scan forthcoming in October. I am worried about the potentiality of teratoma in his one enlarged lymph node, and am wondering if a node larger than 1cm is found (per Mike's earlier comments on another thread), can we do a biopsy instead, rather than jumping into RPLND? What if the node is found to be necrosis?

    If the node has shrunk, does that mean it is likely not teratoma, since it responded to chemo?

    I found on this forum information about Dr. Daneshmand, and have made an appointment for my son for second opinion after CT-scan. Is he the best doctor in Los Angeles area to go for RPLND, if necessary? Are there any high-volume centers in California?

    Thank you for all of your advice and comments.

  • #2
    They base the need for RPLND on the odds of finding teratoma or active cancer in the residual mass after chemotherapy based on size of the residual mass. It they just did a biopsy they get tiny pieces and thus can't accurately tell what is going on in the entire mass. Thus, RPLND is done to take a more in-depth look.

    Let's imagine that the node was 10% teratoma and the chemo shrunk the node by 80%, that means that the teratoma could still present in the node remaining 20% of the node even though the node shrunk in size overall.

    Unless something has recently changed, Dr. Danesmand is the highest volume RPLND surgeon west of the Mississippi River and would be who I would see in Los Angeles, in fact, he is one of a handful of doctors I would select to do an RPLND on me if I needed one. Dr. Aditya Bagrodia recently came to UCSD from UT Southwestern which would be another option, in San Diego, if needed. Other options would be in Northern California, UCSF, Stanford. Again, I personally would be incredibly comfortable with Dr. Danesmand.

    Mike
    Oct. 2005 felt lump but waited over 7 months.
    06.15.06 "You have Cancer"
    06.26.06 Left I/O
    06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
    06.30.06 It's Official - Stage I Seminoma
    Surveillance...
    Founded the Testicular Cancer Society
    6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

    For some reason I do not get notices of private messages on here so please feel free to email me directly at [email protected] if you would like to chat privately so as to avoid any delays.

    Comment


    • #3
      This is distressing, as this shows that even if the node has shrunk, there is still chance of teratoma. Yikes. I guess if that happens, it depends on whether the node is under 1cm and whether it will grow or not in the next few months. But then it could be dangerous to wait, right?

      Thank you for your input on Dr. Daneshmand. That is very helpful!

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      • #4
        Does anyone know how fast teratoma grows? Just thinking of all scenarios here.

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        • #5
          To my knowledge there is no expected growth rate for teratoma. Some can grow slowly while others can be much quicker. That is why there are set follow up schedules to detect any changes.

          Mike
          Oct. 2005 felt lump but waited over 7 months.
          06.15.06 "You have Cancer"
          06.26.06 Left I/O
          06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
          06.30.06 It's Official - Stage I Seminoma
          Surveillance...
          Founded the Testicular Cancer Society
          6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

          For some reason I do not get notices of private messages on here so please feel free to email me directly at [email protected] if you would like to chat privately so as to avoid any delays.

          Comment


          • #6
            Ok...I thought teratoma is slower in growth.

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