Recurrence of acute myeloid leukemia in cryptorchid testis: case report

Abstract

A 23-year-old male with a history of bone marrow transplant for acute myeloid leukemia. He presented a large mass in the right inguinal region 5 years ago. Upon physical examination, right-sided cryptorchidism was observed. The tumor markers alpha-fetoprotein and beta-HCG were within normalcy range and lactate dehydrogenase was raised. Computed tomography of the abdomen and pelvis revealed right testicular mass in contiguity with the inguinal canal to the ipsilateral retroperitoneum, associated with right hydronephrosis. Due to the risk of germ-cell tumor in undescended testicle, the patient underwent radical right orchiectomy. The pathological examination showed recurrence of acute myeloid leukemia in the testis. He was referred to oncology for adjuvant therapy. Our literature review found no similar cases described.

Transepithelial transport across the blood–testis barrier

“…Testicular relapse is the recurrence of cancer in the testis after initial treatment or period of improvement (Arya et al 2010, Locatelli et al 2012. This can occur with testicular cancers such as seminomas or some types of leukemia such as acute lymphoblastic leukemia (ALL) or acute myeloid leukemia (AML) (Dave et al 2007, Arya et al 2010, de Góes et al 2014, Hanna & Einhorn 2014. Both bilateral orchiectomy (removal of both testes), testicular irradiation, and chemotherapy are courses of treatment for relapsed testicular cancers and leukemia (Arya et al 2010, Hanna & Einhorn 2014.…”

“…HIV can be detected in the seminal plasma of patients who have an undetectable viral load in blood serum (Le Tortorec & Dejucq-Rainsford 2010). Cancer cells can also be detected in the testes of patients who have undergone treatment when undetectable in the rest of the body (Grundy et al 1997, Arya et al 2010, Locatelli et al 2012, de Góes et al 2014. Tight junctions, efflux transporters and endogenous transepithelial transport pathways are not only obstacles for cancer and antiviral therapies, they are obstacles for the development of male contraceptives and male fertility treatments (Cheng & Mruk 2012).…”