Abstract
Background: Primary testicular lymphoma (PTL) is an uncommon and aggressive form of extra-nodal non-Hodgkin lymphoma (NHL), accounting for <5.0% of testicular malignancies and 1.0% to 2.0% of NHL cases with a median age at diagnosis of 66 to 68 years. PTL accounts for 1–9% of testicular malignancies and 1–2% of NHLs. There are a handful of described lymphomas in the literature affecting normally positioned testis of aged men, yet none were reported in a cryptorchid middle-aged man. PTL is an extremely aggressive malignancy with poor progression-free survival and overall survival.
Case presentation: A 47-year-old man presented to the urology clinic complaining of multiple painless swellings in the neck and groins. He also complains of back pain, drenching night sweats, a swollen right lower limb, constipation, anorexia, weight loss, and occasional vomiting. The illness's duration is 2 months. He had a right inguinal testis. Histology examination of the excised testis and lymph nodes revealed an advanced “diffuse large beta-cell lymphoma” in both. The patient was referred for oncology care.
Conclusion: It is an extremely rare case of Diffuse Large B-Cell Lymphoma (DLBCL) in the undescended testis of a middle-aged man. To the best of our knowledge, this is the first published case of its kind about the tumor's type, testis anomaly, and patient's age.
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References
- Gundrum JD, Mathiason MA, Moore DB, Go RS. Primary testicular diffuse large B-cell lymphoma: a population-based study on the incidence, natural history, and survival comparison with primary nodal counterpart before and after the introduction of rituximab. J Clin Oncol. 2009;27(31):5227-5232. DOI: 10.1200/JCO.2008.19.9115.
- Shahab N, Doll DC. Testicular lymphoma. Semin Oncol. 1999; 26:259–269.
- Ahmad SS, Idris SF, Follows GA, Williams MV. Primary testicular lymphoma. Clin Oncol (R Coll Radiol). 2012 Jun;24(5):358-65. doi: 10.1016/j.clon.2012.02.005.
- Vitolo U, Ferreri AJ, Zucca E. Primary testicular lymphoma. Crit Rev Oncol Hematol. 2008 Feb;65(2):183-9. doi: 10.1016/j.critrevonc.2007.08.005.
- Cheah CY, Wirth A, Seymour JF. Primary testicular lymphoma. Blood. 2014 Jan 23;123(4):486-93. doi: 10.1182/blood-2013-10-530659.
- King RL, Goodlad JR, Calaminici M, Dotlic S, Montes-Moreno S, Oschlies I, Ponzoni M, Traverse-Glehen A, Ott G, Ferry JA. Lymphomas arising in immune-privileged sites: insights into biology, diagnosis, and pathogenesis. Virchows Arch. 2020 May;476(5):647-665. doi: 10.1007/s00428-019-02698-3.
- Ollila TA, Olszewski AJ. Extranodal Diffuse Large B Cell Lymphoma: Molecular Features, Prognosis, and Risk of Central Nervous System Recurrence. Curr Treat Options Oncol. 2018 Jun 21;19(8):38. doi: 10.1007/s11864-018-0555-8.
- Darby S, Hancock BW. Localised non-Hodgkin lymphoma of the testis: the Sheffield Lymphoma Group experience. Int J Oncol. 2005 Apr;26(4):1093-9.
- Xu H, Yao F. Primary testicular lymphoma: A SEER analysis of 1,169 cases. Oncol Lett. 2019 Mar;17(3):3113-3124. doi: 10.3892/ol.2019.9953.
- Banks K, Tuazon E, Berhane K, Koh CJ, De Filippo RE, Chang A, Kim SS, Daneshmand S, Davis-Dao C, Lewinger JP, Bernstein L, Cortessis VK. Cryptorchidism and testicular germ cell tumors: comprehensive meta-analysis reveals that association between these conditions diminished over time and is modified by clinical characteristics. Front Endocrinol (Lausanne). 2013 Feb 18; 3:182. doi: 10.3389/fendo.2012.00182.
- Ferguson L, Agoulnik AI. Testicular cancer and cryptorchidism. Front Endocrinol (Lausanne). 2013 Mar 20; 4:32. doi: 10.3389/fendo.2013.00032.
- King RL, Goodlad JR, Calaminici M, Dotlic S, Montes-Moreno S, Oschlies I, Ponzoni M, Traverse-Glehen A, Ott G, Ferry JA. Lymphomas arising in immune-privileged sites: insights into biology, diagnosis, and pathogenesis. Virchows Arch. 2020 May;476(5):647-665. doi: 10.1007/s00428-019-02698-3.
- Pollari M, Leivonen SK, Leppä S. Testicular Diffuse Large B-Cell Lymphoma-Clinical, Molecular, and Immunological Features. Cancers (Basel). 2021 Aug 11;13(16):4049. doi: 10.3390/cancers13164049.
- Sénéchal C, Saint F, Petit T, Petit J. Lymphomes non hodgkiniens primitifs du testicule : pronostic à long terme associé au traitement combinant chimiothérapie systémique et intrathécale [Non-Hodgkin's primitive lymphoma of the testis: long-term prognosis associated with treatment combining systemic and intrathecal chemotherapy]. Prog Urol. 2009 Mar;19(3):209-14. French. doi: 10.1016/j.purol.2008.11.011.
- Rotaru I, Nacea JG, Foarfă MC, Ciovică DV, Pătraşcu AM. Primary diffuse large B-cell lymphoma of the testis. Romanian Journal of Morphology and Embryology. 2018;59(2):585–589.
- Yadav C, Ahmad A, D'Souza B, Agarwal A, Nandini M, Ashok Prabhu K, D'Souza V. Serum Lactate Dehydrogenase in Non-Hodgkin's Lymphoma: A Prognostic Indicator. Indian J Clin Biochem. 2016 Apr;31(2):240-2. doi: 10.1007/s12291-015-0511-3.
- Donghua He, Fangshu Guan, Wenjun Wu. Anaplastic large cell lymphoma in undescended testis of a patient with 46, XY disorder of sex development (DSD): a case report. Int J Clin Exp Med 2018;11(10):11257-11261.
