To report the case of a patient with clinical stage IA pure seminoma, managed with surveillance, who participated in a prospective study of serial miRNA (miR-371a-3p and miR-372-3p) testing as a means of highlighting the potential role that novel serum biomarkers may have in the management of patients with early-stage testicular cancer.
We report the patient's clinical course, relevant diagnostic studies, treatment and outcomes focusing on how miRNA levels indicated a relapse prior to traditional imaging and serum tumor markers. We also provide a roadmap for potential implementation of miRNA testing as part of surveillance for early-stage testicular cancer.
This is a case of a 43 year-old male with CSIA seminoma who was treated initially with an orchiectomy and then managed with surveillance according to established clinical guidelines. Conventional STMs remained non-elevated and serial cross-sectional imaging was negative through 18 months of surveillance. At 21 months, miRNA testing (miR-371a-3p and miR-372-3p) converted to positive; shortly thereafter, routine computed tomography (CT) scan at the 24-month mark of surveillance revealed a new 4.3 × 3.7 cm right common iliac nodal mass consistent with metastatic seminoma. The patient was subsequently treated with chemotherapy and had a complete response.
This case illustrates that miRNA-informed surveillance may detect relapse in early-stage testis cancer prior to traditional diagnostics. Incorporating miRNA assays into surveillance algorithms could lead to risk-adjusted and non-invasive monitoring thus reducing dependence on repeated axial imaging. Prospective, standardized protocols and assay harmonization are needed prior to routine clinical integration in the early-stage setting.
Urology. 2025 Dec 05 [Epub ahead of print]
Jonathan Huynh, Adam Levin, Vincent D'Andrea, Brandon Williams, Andrea Knezevic, Joel Sheinfeld, Fei Ye, Alisa Valentino, Darren R Feldman, Samuel A Funt, Richard S Matulewicz
Icahn School of Medicine at Mount Sinai, New York, New York., Cornell University, Ithaca, New York., Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York., Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York., Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, New York., Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, New York. Electronic address: .
PubMed http://www.ncbi.nlm.nih.gov/pubmed/41354280