Synchronous Primary Testicular Tumor: a case report of diffuse large B-cell lymphoma

Authors

DOI:

https://doi.org/10.48193/5ys34h17

Keywords:

Primary testicular lymphoma, diffuse large-B cell lymphoma, orchiectomy, testis cancer, testicular chemotherapy

Abstract

Case description: 63-year-old man of with 7-month history of progressive and gradual increase in testicular size without pain, symptoms of local or systemic infection. Biomarkers for testicular neoplasia were within the reference range: LDH(167 U/L), AFP( 1.49 IU/mL), and HCG( 0.2 mUI/mL). MR): enlarged testicular dimensions showing nodular lesions of heterogeneous enhancement. The patient initially underwent a inguinal orchiectomy who revealed diffuse large B-cell lymphoma.

Relevance: primary testicular lymphoma (PTL) is a rare non-Hodgkin lymphoma (NHL) that occurs in 1–2% of all cases of NHL and commonly presents as diffuse large B-cell lymphoma in 80–90% of cases. Bilateral and synchronous lesions are observed in 1–2% and 10% of cases, respectively. In this report, we describe our experience regarding this cancer.

Clinical implications: if not properly conducted, it can end in advanced disease with no prospect of cure, infertility, primary hypogonadism and psychological alterations due to the removal of the gonads.

Conclusions: PTL is a rare malignancy associated with high recurrence rates and poor prognosis, and multimodal therapy is warranted to achieve better long-term survival and cure rates.

 

Author Biographies

  • Vitor Pereira Xavier Grangeiro , Sistema Único de Salud del Municipio de João Pessoa, Paraíba, Brasil.

    Ministry of Health of Brazil, Unified Health System

  • Carmelita Félix Dantas de Oliveira, Sistema Único de Salud del Municipio de João Pessoa, Paraíba, Brasil.

    Ministry of Health of Brazil, Unified Health System

References

Laguna MP, Albers P, Algabara F, Bokemeyer C, Boormans J L, Fischer S, et al. EUA Guidelines on Testicular Cancer. 2020.

Sia NPX, Chekrine T, Bourhafour M, Ouadii K, Bouchbika Z, Benchakroun N, et al. Primary Testicular Lymphoma: A Case Report and Review of the Literature. Journal of Cancer Therapy. 2022;13(3): 145–154. https://doi.org/10.4236/jct.2022.133011.

Campobasso D, Ferretti S, Frattini A. Synchronous bilateral testis cancer: clinical and oncological management. Contemporary Oncology. 2017;21(1): 70–76. (8).

Medina AA, Lorca Álvaro J, Carretero del Barrio I, Laso García I, García Cosío M, Mata Alcaraz M, et al. Primary testicular lymphoma: Clinical characteristics and oncological outcomes. Current Urology. 2023;17(2): 130–134. https://doi.org/10.1097/cu9.0000000000000137

Rossi A, Orecchioni S, Falvo P, Tabanelli V, Baiardi E, Agostinelli C, et al. Dual targeting of the DNA damage response pathway and BCL-2 in diffuse large B-cell lymphoma. Leukemia. 2022;36(1): 197–209. https://doi.org/10.1038/s41375-021-01347-6.

Zhi Y, Bao S, Mao J, Chai G, Liu C, Zhu J. Development and validation of a survival nomogram in patients with primary testicular diffuse large B-cell lymphoma. The Journal of International Medical Research. 2023;51(9): 3000605231197052. https://doi.org/10.1177/030006052311970.

Shing Oh K, Prajapati S, Mahalingam M. Diffuse large B-cell lymphoma of the skin and testis: A diagnostic and staging dilemma. Indian Journal of Dermatology, Venereology and Leprology. 2023;89(1): 79–81. https://doi.org/10.25259/ijdvl_882_2021.

Liu KT, Chang YC, Lin YC, Chang JL. Unusually aggressive primary testicular diffuse large B-cell lymphoma initially presenting as systemic disseminating metastases in older adult men: a case report. Annals of Medicine and Surgery (2012). 2023;85(8): 4106–4111. https://doi.org/10.1097/ms9.0000000000001018.

Sehn LH, Salles G. Diffuse Large B-Cell Lymphoma. The New England Journal of Medicine. 2021;384(9): 842–858. https://doi.org/10.1056/nejmra2027612.

Trama F, Illiano E, Aveta A, Pandolfo SD, Bertuzzi G, Costantini E. Bilateral Primary testicular diffuse large B-CELL lymphoma. Urology Case Reports. 2021;38: 101733. https://doi.org/10.1016/j.eucr.2021.101733.

Singh R, Shaik S, Negi BS, Rajguru JP, Patil PB, Parihar AS, et al. Non-Hodgkin’s lymphoma: A review. Journal of Family Medicine and Primary Care. 2020;9(4): 1834–1840. https://doi.org/10.4103/jfmpc.jfmpc_1037_19.

Orellana-Noia V, Abousaud A. Secondary Central Nervous System Lymphoma: Updates in Treatment and Prophylaxis Strategies. Current Treatment Options in Oncology. 2022;23(10): 1443–1456. https://doi.org/10.1007/s11864-022-01017-4.

King RL, Goodlad JR, Calaminici M, Dotlic S, Montes-Moreno S, Oschlies I, et al. Lymphomas arising in immune-privileged sites: insights into biology, diagnosis, and pathogenesis. Virchows Archiv: An International Journal of Pathology. 2020;476(5): 647–665. https://doi.org/10.1007/s00428-019-02698-3.

Spinner MA, Advani RH. Current Frontline Treatment of Diffuse Large B-Cell Lymphoma. Oncology (Williston Park, N.Y.). 2022;36(1): 51–58. https://doi.org/10.46883/2022.25920940.

Schepisi G, De Padova S, De Lisi D, Casadei C, Meggiolaro E, Ruffilli F, et al. Psychosocial Issues in Long-Term Survivors of Testicular Cancer. Frontiers in Endocrinology. 2019;10: 113. https://doi.org/10.3389/fendo.2019.00113.

Elenkov A, Giwercman A. Testicular Dysfunction Among Cancer Survivors. Endocrinology and metabolism clinics of North America. 2022;51(1). https://doi.org/10.1016/j.ecl.2021.11.014

Downloads

Published

2024-01-22

Issue

Vol. 83 No. 6 (2023): November-December

Section

Clinical cases

License

Copyright (c) 2024 Revista Mexicana de Urología

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.