Hey friends,
I was diagnosed with Nonseminomatous Testicular Cancer in January 2023 after a range of symptoms prompting an ultrasound. Tumor markers came back elevated. Had a right orchiectomy a few days later, and the biopsy showed mixed components of embryonal carcinoma, yolk sac tumor, and teratoma. While my tumor markers subsided, they started rising soon after, leading to 3 cycles of BEP that summer.
I have followed the strict protocol of CT and blood tests ever since. However, last month, just before my two year milestone, a CT showed a new, lone 2 cm growth in the retroperitoneal lymph nodes. LDH and AFP have increased but remain in the normal range. The assumption is this is probably teratoma and we can settle the score for good with a PC-RPLND surgery. It's scheduled for next month (9/8).
Here's the problem—while waiting for my surgery, I've had pretty regular lower back pain, increasing blood pressure, and then discovered a small bump on my thigh. I thought it was unrelated to the cancer, maybe a blood clot or something, but after an ultrasound last night, they found a solid superficial heterogeneous mass, measuring 3.3 x 0.7 x 2.7 cm. The mass is hyperechoic with a hypoechoic center and vascularity, suggesting a new, malignant tumor.
I am at a complete loss here, as I have found only one reported case in the medical literature of testicular cancer spreading into soft tissue of the thigh instead of the usual sites (lungs, brain, etc.). Instead, I am reading across the board about soft-tissue sarcoma, which often appear in the thigh and retroperitoneum. And because TC surveillance protocol does not scan the legs, we have no idea how long this tumor has been in my thigh nor if it predates the tumor in the retroperitoneum.
I am waiting to hear back from my oncologist, which (as most of you know) can take days if not weeks in our medical system. I am struggling to find any evidence of this being testicular cancer online, and instead am seeing a lot of evidence of soft-tissue sarcoma. Is it possible that my retroperitoneal tumor is not TC but an altogether different, new cancer? Wouldn't having my PC-RPLND surgery now be the wrong approach if this were the case?
While the next steps would appear to be getting a biopsy of the tumor in my thigh, I am so familiar with TC treatment that I am wary of biopsies—they say it could spread the cancer even further. My PC-RPLND surgery is two weeks away. I have no idea what to do! Does anyone have experience or knowledge of situations like mine?