Teratoma after RPLND followed by chemo

[David1969]

Has anybody come across a situation where somebody has undergone an RPLND follwoed by 2 rounds of chemo (BEP) and then found they have teratoma?

[sldl1106]

I'm not a veteran here but I haven't heard of that. Is this happening to you?

[David1969]

Potentially. I have just had my CT scan and 2 nodes are enlarged (blood counts fine) my oncologist thinks there is a 65% it is teratoma or a 35% chance it is a return of the cancer.

If its Teratoma I guess the question is, was the first RPLND done correctly?

[sldl1106]

I'm not sure. If there was a dot of live teratoma that wasn't removed during RPLND, it would just continue to grow. Chemo may have killed the teratoma but not shrunk it; my husband's was very large and barely shrank at all from 3xBEP and 1xEP. I don't know if a teratoma would just start growing on its own after surgery and chemo. I'm sure someone else here has something more enlightening to share than I have.

Was this your first CT post chemo?

[Already Bald]

I think a member named Vinny had to have teratoma remoed from his lung post chemo. He had VAT Surgery.

What is the next step your oncologist recommends?
(Have you had a second opinion?)

[David1969]

My oncologist is recommending a Biopsy next week, I am hoping to have a call with my urologist tomorrow.

I have an appointment for a second opinion but it is after the Biopsy, so I guess I will see what results I get from that.

[Scott]

If its Teratoma I guess the question is, was the first RPLND done correctly?

That's a reasonable question. Were all retroperitoneal lymph nodes removed as a package? Was it bilateral, removing lymph nodes on both sides of the body? If not, are the enlarged nodes on the opposite side?

[David1969]

I am waiting for a copy of the scan so not sure what side the nodes are on. My RPLND was left side only as far as I am aware.

[Fed]

To answer the original question, teratoma usually does not respond to chemo, so any that was left behind (or micrometastases) could potentially spring up again.

[David1969]

I think one of the problems which may of caused this is that on my original RPLND the surgeopn initially thought they were completely clear, only when the path report came back did it show very minute quantaties of cancer in 2 nodes.

I am hanging on to the hope, that this might of mean the may of missed a couple and the chemo killed the cancer, rather than a recurrence.

[Already Bald]

I have an appointment for a second opinion but it is after the Biopsy, so I guess I will see what results I get from that.

Okay, the second opinion is after the biopsy- that is good. The doctor will be better educated on your case. Hopefully all the doctors will talk to each other.
Try to hang in there David.
Joe

[dadmo]

David:
Where did you have your RPLND done and who are you using for a second opinion?

[Karen]

David,
The second opinion will be important, so please use an expert if you can. Hang in there and keep us updated when you can.

[David1969]

I had the RPLND done by Dr. Laudone at Hartford, CT.

I am seeing a Dr Siegil also at Hartford for a second opinion.

[Karen]

David,
Just my 2 cents here, , but when docs are colleagues from the same hospital or group they will usually not contradict each other, so your second opinion may be a second doctor reiterating what the first one said to be collegial. I suggest you go outside that group with a consult at DFCI or Sloan for an unbiased second opinion.