TITLE:
Primary Testicular Lymphoma: A Case Report and Review of the Literature
AUTHORS:
Nioka Pierre Xavier Sia, Tarik Chekrine, Mouna Bourhafour, Karima Ouadii, Zineb Bouchbika, Nadia Benchakroun, Hassan Jouhadi, Nezha Tawfiq, Abdellatif Benider, Farida Marnissi, Abdellah Madani, Mehdi Karkouri, Souha Sahraoui
KEYWORDS:
Primary Testicular Lymphoma, Diffuse Large-B Cell Lymphoma, Orchiectomy, Chemotherapy, Radiotherapy, Testis
JOURNAL NAME:
Journal of Cancer Therapy,
Vol.13 No.3,
March
21,
2022
ABSTRACT: Background and Aim:Primary testicular lymphoma (PTL) is a rare form of extranodal non-Hodgkin’s lymphoma. It represents
for 1% - 2% of non-Hodgkin’s lymphoma, and mostly
affects the elderly. We describe an interesting case of PTL managed by a
combined multimodal approach with a review of the literature. Case Presentation: Patient aged 56 years,
consulted for an increase in the volume of the right testicle without
associated pain, all evolving in the context of a slight decline in general
condition. Clinical examination revealed a large painless mass in the right
scrotal bursa. A scrotal ultrasound showed a right intra-testicular mass. The
patient had undergone inguinal orchiectomy. Pathological analysis showed
diffuse large B-cell lymphoma of the testis. Whole-body 18-fluorodeoxyglucose
positron emission tomography (18-FDG-PET-CT) showed no suspicious
hypermetabolism. Lumbar puncture did not reveal malignant cells in the
cerebrospinal fluid (CSF). The patient then received 6 cycles of chemotherapy
according to the R-CHOP protocol (Rituximab, Cyclophosphamide, Doxorubicin,
Vincristine, and Prednisone) and 2 cycles of intrathecal methotrexate. After
chemotherapy, scrotal radiotherapy at a dose of 30 Gy was delivered. The
evolution was marked by the death of the patient six months after the end of
the scrotal radiotherapy following a diffuse lymph node relapse with a profound
alteration of the general state. Conclusion: The treatment depends imperatively on the stage of the
disease. The therapeutic approach is multimodal and combined based on
orchiectomy, systemic and intrathecal treatment and scrotal radiotherapy. PTL
is an aggressive malignant with a poor prognosis. Randomized trials are needed
to define a better therapeutic strategy.