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  • Choriocarcinoma

    I have been reading different threads and i see some posts about choriocarcinoma and how it is more serious than the other cell types? is this true? i see some peoples HCG through the roof , does this have any relation?
    to this day, we still dont know what Brians cell makeup is i know this is not good,but i dont remember them telling me. i think teratoma is present, maybe thats why they want all of the tumors out?

    Dawn

    Hope everyone had a great weekend!
    Fiance Brian, dx:stage IIIC non-sem 4/18/07
    mets to lungs,liver,abdomin,large tumor near kidney
    hcg was 176,000!
    completed 1 rnd of TIP(had bad reaction to taxol)
    BEPx3 until 7/13/07
    7/26/07 post chemo ct-scan shwd shrinkage & fewer lung tumors
    10/17/07 @ MSKCC Liver FREE of cancer! necrotic & small focus of teratoma.
    AFP & HCG normal
    12/7/07 RPLND,right orchiectomy @ MSKCC
    12/18/07, rcvd pathology,all clear! no cancer!
    2/11/08 -Lung surgery dne @ MSKCC
    ALL CLEAR

  • #2
    Choriocarcinoma is the rarest of the germ cell tumors. Chorio only accounts for 1% of the cases. Most of the times, it is found as a minute component of mixed type non-seminomas, and very rarely is it found in pure form. As all cancer cells, chorio is confused: they are wannabe placental tissue. This confers two important properties. First, they always produce bHCG, the pregnancy hormone; hence, this is why people with chorio always show high bHCG levels. Second, since placental tissue acts as a conduit to the bloodstream, chorio mestastasizes very aggressively through the vasculature, moreso than other GCTs.

    The problem with teratomas is that they contain components of normal cells, and because of this behavior, they are resistant to chemo and need to be resected if found. The real danger with teratomas (particularly immature ones) is that they can morph into adenocarcinomas or sarcomas, which are completely different from GCTs and require a other forms of treatment.

    Hope this answers your question.
    "Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
    11.22.06 -Dx the day before Thanksgiving
    12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! I consider myself cured.

    Comment


    • #3
      Dawn,

      I also want to mention from most everything I have read about Choriocarcinoma is when it is just a percentage of a tumor it isn't nearly as dangerous as when it is 100% Choriocarcinoma. When it is 100%, it is quite a battle for those with it, I think mostly because it is SO darn agressive.

      But if his original tumore had teratoma in it, it is very likely the percentage of Choriocarcinoma was very low, like less the 5%.

      That is just from what I have read, by no means an expert opinon!

      And teratoma would be why they want it all out. Of course I am sure they want it all out regardless, it is cancer, it needs to come out!

      I hope things are staying as calm for you as it can. Lots of deep breathing!

      Becki

      Husband Right I/O 09/06
      -70% Embryonal Carcinoma
      -20% Teratoma
      -10% Yolk Sac Tumor
      11/06- lymph nodes 1.8x1.4 and 1.9x1.4
      12/06-PET Scan confirms activity in lymph nodes, lymph nodes 2.2x2.2 and 2.4x2.3
      1/07-Start 3xBEP
      4/07-PET clear, lymph nodes down to 1.1x0.5 and 1.8x1.0
      6/07-lymph nodes 1.2x1.0 and 1.9x.9
      8/07-lymph nodes 1.1x1.0 and 2.0x1.2
      10/07-lymph nodes 2.0x1.5 and 2.7x1.8
      11/07- PostChemo LRPLND-found burnt out teratoma
      11/09-Enlarging lymph node 1.2 cm near renal veins

      Comment


      • #4
        Hi Dawn,
        Steve's cell type is 100% choriocarcinomas. Which we were told is the rarest type and fastest spreading. Steve's HCG count was through the roof. When he was diagnosed on April 16 it was 444,321. 13 days later, on April 30th it almost doubled to 777,463. When the Dr. seen that, Steve started chemo May 1st. There was no time to waste.

        Now we are so thankful that it is down to 3!

        Comment


        • #5
          Wow Dollfin, that is wonderful that his HcG has normalized.

          Dawn, don't worry. Rob and I didn't know what his tumor type was because it had burnt out in the testicle so the I/O didn't give us any information. Right after the RPLND we were told it was probably all non-sem and mature teratoma, because the pathologist was there, and it wasn't until a week after the RPLND we knew for sure. I too was worried about chorio.

          But, still lurking in the back of my mind is that there was a tiny bit of each kind live within the necrotic tissue; I won't be able to breathe right until his first true blood test comes back, and he's not even going for the bloodwork until I think the 16th of this month.
          Rob and Stacy
          DX: 3/10/05, AFP: 15,047, L I/O: 3/28/05, Yolk sac tumor & teratoma, Stage IIIC, 3xBEP & 1xEP: 4/4/07 - 6/25/07, AFP: 14, RPLND 8/10/07, w. left kidney removed. 10/19/07, AFP: 1.9

          Comment


          • #6
            I am so glad I read this thread. I have felt so guilt because I dont know what my son's TC is made up of. All I remember is that is was a mixed germ cell with teratomas and something about looking like a placenta.

            I am so glad that both guys numbers are down.
            My son's is going up. But we are still fighting with TIP now.
            I guess I need to add his info at the need.
            Diagnosed 5/6/07 Right Removal 5/8/07 Finished 4x BEP 7/30/07 CAT scans showed spots on liver, 12 in lungs, and 5 cm mass in lymph nodes still present after chemo. Spot in brain had clear up. HCG 19 7/30/07 HCG 999 9/27/07 Started TIP 10/2/2007
            Son Les diagnosed 5/7/07-Right I/0 5/9/07-Stage 3C Non-seminoma Mixed Cell Germ Tumor-Tumors in liver, lungs, lymph nodes, brain-4XBED Finished 7/31/07 HCG 9 tumors smaller, brain lesion gone-9/30/07 HCG 999-TIPx4 started 10/2/07, IU 11/29 Told he had Choriocarcinoma Syndrome HDC and Stem Cell Transplant to begin 1/3/08 Finished Transplant 3/1/08 HDC and Stem Cell Transplant Failure 3/20. 4/17 RPLND & Liver resection, Molecular profiling of tumor, 6/2 Hospice Services- Passed Away 12/12/08

            Comment


            • #7
              Pam,
              There's a lot of strength and hope on this site...and I'm sending lots out to you and Les.
              Retired moderator. Husband, left I/O 16Dec2005, stage I seminoma with elevated b-HCG, no LVI, RTx15 (25Gy). All clear ever since.

              Comment


              • #8
                I do remember that when Brian was 1st in sloan kettering, one of the fellows came in and discussed wth us the different types of cells, all i remembered was that it was non-seminoma, everything was just a big blurr that day
                then we just never got the answers. Brian also had a biopsy of the tumor in his back in the begining but we didnt find out then either. so, i know some is teratoma, but how does teratoma, being benign, grow when there are malignant cells there? it just seems odd how some bad is growing, but then teratoma comes along and is not malingnant?
                Fiance Brian, dx:stage IIIC non-sem 4/18/07
                mets to lungs,liver,abdomin,large tumor near kidney
                hcg was 176,000!
                completed 1 rnd of TIP(had bad reaction to taxol)
                BEPx3 until 7/13/07
                7/26/07 post chemo ct-scan shwd shrinkage & fewer lung tumors
                10/17/07 @ MSKCC Liver FREE of cancer! necrotic & small focus of teratoma.
                AFP & HCG normal
                12/7/07 RPLND,right orchiectomy @ MSKCC
                12/18/07, rcvd pathology,all clear! no cancer!
                2/11/08 -Lung surgery dne @ MSKCC
                ALL CLEAR

                Comment


                • #9
                  Originally posted by sldl1106
                  Dawn, don't worry. Rob and I didn't know what his tumor type was because it had burnt out in the testicle so the I/O didn't give us any information.
                  hi stacy, Brians tumor in his testicle is also burnt out, but he has yet to have the O/I. we were told that in the beginning when he had his 1st testicular sonogram.
                  Last edited by Fed; 10-09-07, 09:57 AM. Reason: Added quote tags
                  Fiance Brian, dx:stage IIIC non-sem 4/18/07
                  mets to lungs,liver,abdomin,large tumor near kidney
                  hcg was 176,000!
                  completed 1 rnd of TIP(had bad reaction to taxol)
                  BEPx3 until 7/13/07
                  7/26/07 post chemo ct-scan shwd shrinkage & fewer lung tumors
                  10/17/07 @ MSKCC Liver FREE of cancer! necrotic & small focus of teratoma.
                  AFP & HCG normal
                  12/7/07 RPLND,right orchiectomy @ MSKCC
                  12/18/07, rcvd pathology,all clear! no cancer!
                  2/11/08 -Lung surgery dne @ MSKCC
                  ALL CLEAR

                  Comment


                  • #10
                    Originally posted by DAWN82
                    [...] but how does teratoma, being benign, grow when there are malignant cells there? it just seems odd how some bad is growing, but then teratoma comes along and is not malingnant?
                    This is a bit inaccurate. Teratomas in males are always malignant, which is not the case for ovarian teratomas. Remember my analogy about the confused cells? Well, teratomas are far more confused. When an embryo develops, there are three layers of cells that are clearly demarkated. Each layer will develop into the different organs that make the human body. In a teratoma, all of the layers are jumbled around and mixed with each other. In some specimens, you can find bone tissue next to intestinal epithelium, surrounded by neuronal tissue with a hint of liver cells (they look really messed up under the scope). The "benign cell behavior" arises from the fact that these cells divide too slowly to be easily eliminated by chemo, and since they are developing abnormally, they can degenerate into other cancers that are actually more malignant and invasive than TC.
                    "Life moves pretty fast; if you don't stop and look around once in a while, you could miss it." -Ferris Bueller
                    11.22.06 -Dx the day before Thanksgiving
                    12.09.06 -Rt I/O; 100% seminoma, multifocal; Stage I-A; Surveillance; Six years out! I consider myself cured.

                    Comment


                    • #11
                      Originally posted by Fed
                      This is a bit inaccurate. Teratomas in males are always malignant, which is not the case for ovarian teratomas. Remember my analogy about the confused cells? Well, teratomas are far more confused. When an embryo develops, there are three layers of cells that are clearly demarkated. Each layer will develop into the different organs that make the human body. In a teratoma, all of the layers are jumbled around and mixed with each other. In some specimens, you can find bone tissue next to intestinal epithelium, surrounded by neuronal tissue with a hint of liver cells (they look really messed up under the scope). The "benign cell behavior" arises from the fact that these cells divide too slowly to be easily eliminated by chemo, and since they are developing abnormally, they can degenerate into other cancers that are actually more malignant and invasive than TC.
                      THANK YOU FOR CLEARING THAT UP FED, I UNDERSTAND IT MUCH BETTER NOW ....... SO I GUESS ITS A GOOD THING THAT THEY ARE COMING OUT
                      Fiance Brian, dx:stage IIIC non-sem 4/18/07
                      mets to lungs,liver,abdomin,large tumor near kidney
                      hcg was 176,000!
                      completed 1 rnd of TIP(had bad reaction to taxol)
                      BEPx3 until 7/13/07
                      7/26/07 post chemo ct-scan shwd shrinkage & fewer lung tumors
                      10/17/07 @ MSKCC Liver FREE of cancer! necrotic & small focus of teratoma.
                      AFP & HCG normal
                      12/7/07 RPLND,right orchiectomy @ MSKCC
                      12/18/07, rcvd pathology,all clear! no cancer!
                      2/11/08 -Lung surgery dne @ MSKCC
                      ALL CLEAR

                      Comment


                      • #12
                        Dawn, when you say you never got the answers after the biopsies, do you mean the biopsies were inconclusive or that the docs never told you the specific types? If it's the latter, you can ask the docs to fax you copies of the pathology reports.

                        Comment


                        • #13
                          Fed, thank you for all the information on Teratoma. Jon had it throughout is lymphatic system and although doctors explained what it was, there was always a level of "now what is teratoma again" between Jon and I. Luckily the surgeons removed all of it from Jon, but I still find it frustrating that I didn't fully understand what it was. So Thanks!
                          Lori and Jon
                          Diagnosed 5/22/2006
                          I/O 5/26/2006, Stage 3, Good
                          Teratoma (Majority), Seminoma (10%), Yolk Sac
                          3xEP then determined not working
                          HDC w/stem cell transplant 8/16/06 to 9/25/06
                          Chest and Neck surgery 10/9/06 - immature teratoma
                          RPLND 11/16/06 - immature Teratoma
                          2/29/2008 - markers continue to be normal!
                          9/16/2008 - released from Dr. Einhorn's care

                          Comment


                          • #14
                            Fed, I have such a crush on you and all your detailed explanations for us.
                            Rob and Stacy
                            DX: 3/10/05, AFP: 15,047, L I/O: 3/28/05, Yolk sac tumor & teratoma, Stage IIIC, 3xBEP & 1xEP: 4/4/07 - 6/25/07, AFP: 14, RPLND 8/10/07, w. left kidney removed. 10/19/07, AFP: 1.9

                            Comment


                            • #15
                              Originally posted by sldl1106
                              because it had burnt out in the testicle
                              Hey Fed, what exactly does "burnt out in the testicle" mean? - never heard that term used before
                              "Faith is being sure of what we hope for and certain of what we do not see". Heb 11:1

                              Comment

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