understanding an RPLND Pathology report!

[nzsteve]

Hi All,

Long shot here, but I don't suppose anyone is any good at interpreting pathology reports are they? Ive got my oncology follow up following my RPLND on the 18th, but my GP has managed to get hold of the pathology report for me to have a look at early. Only problem is now I dont really know what it means

Most of the report lists lymph nodes as 'no evidence of malignancy' (which sounds pretty good), but the enlarged node is reported as:

"Sections show a non seminomatous germ cell tumour exhibiting chemotherapy induced maturation. This comprises numerous nests of mature cartilage which is cellular and exhibits cytologic atypia, Also present are glandular structures lined by respiratory epithelium, mature neural tissue including gemistocytes, squamous epithelium and intestinal type epithelium. Very focally an area of immature stroma is identified.

No embryonal carcinoma or yolk sac tumour is seen.

The tumour approaches the resection margin however does not appear to have been transected at the margins.

Two further nodules of teratoma were identified seperatly within the mesentery together with 7 lymph nodes showing reactive change only.

SUMMARY: Left para-aortic lymph node - non seminomatous germ cell tumour showing chemotherapy induced maturation"

Im lost in all that, other than knowing/guessing its not great and I'll probably need some more chemo. If anyone can help explain it would be much appreciated!

If it helps, my original report from the testicular tumour was 40% immature terratoma, 30% embryonal carcinoma, 20% yolk sac, minor componant seminoma.

Thanks,

Steve

[nzsteve]

I think (after a couple of hours googling medical terms!) that 'chemotherapy induced maturation' is the key part... just need to work out what they mean by it

If anyones seen it or something similar in a report please let me know!

ta,

Steve

[danebert]

congads, it basically means you have teratoma, mature teratoma, with a tiny bit of immature teratoma. Teratoma most often looks like cells in other parts of the body such as hair, bone, ect. It is undifferentated whichis a good thing. It basically means you are all clear.

[nutless1]

No embryonal carcinoma or yolk sac tumour is seen.

Thats good they could have found some.

The tumour approaches the resection margin however does not appear to have been transected at the margins

Thats good looks like they cut it all out.

SUMMARY: Left para-aortic lymph node - non seminomatous germ cell tumour showing chemotherapy induced maturation.

Looks like whatever was there before Chemo has been killed by it.

[nzsteve]

Cheers - I wont get too excited until I see the Doc next week, but thats exactly what I wanted someone to say

Steve

[matthias]

Not to p**s on your cake, but:

Immature teratoma is a highly malignant neoplasm; treatment of immature teratoma by chemotherapy can result in maturation to give you, you guessed it, mature teratoma.

Mature teratoma are a benign histology that has significant malignant potential and requires complete surgical excision and close surveillance. Notably, postchemotherapy mature teratomas cannot be treated with chemotherapy or radiation.

Also mature teratoma can transform into neoplasms you don't want to know about, for example, rhabdomyosarcomas for which treatment is difficult at best.

So, for the time being you are cured (after all, mature teratomas are benign) but you will probably require further surgery to excise the benign growth.

And no, I am not a surgical oncologist...I just stay at Holiday Inn Express (in reference to an ad campaign running here on TV). Nevertheless, if I am right send me a few bottles of Marlborough...

Added in Edit: Of course, you already had, hopefully all, benign teratoma surgically removed by the RPLND. If so, best wishes and don't forget your fellow TC afflicts: soon we will just be a distant memory!