Abnormal presentation of a bilateral, synchronous and plurimetastatic medium and large cell testicular lymphoma: A case report

Abstract

Primary testicular lymphoma (PTL) accounts for 1-2% of all cases of non-Hodgkin's lymphoma, with a higher incidence in patients aged >60 years. The most common histological subtype is diffuse large-cell B lymphoma. By contrast, the bilateral synchronous and multimetastatic clinical presentation is a rare and unusual clinical presentation. In testicular masses, orchiectomy is essential for histopathological evaluation of the disease and definition of the immunophenotypic structure. The present study reported the case of a paucisymptomatic 54-year-old patient, who presented with erectile dysfunction and increasing testicular volume. Although clinical assessment and ultrasound examination showed an abnormal structure, highly suspicious for testicular cancer, the subsequent bilateral radical orchiectomy permitted the diagnosis of an unusual and rare PTL with multiple metastases reported at the PET/CT scan. In conclusion, the rare and aggressive disease represented by PTL requires a multidisciplinary approach and an aggressive treatment in order to provide the best care for patients affected.

Next-generation sequencing of primary testicular lymphoma and relapse in the glans penis after prophylactic radiation therapy: a rare case report

“…Although other extranodal sites of relapse reportedly include Waldeyer’s ring and the skin, no report has described relapse in the glans penis [ 1 , 3 , 4 , 6 ]. A rare case of bilateral synchronous testicular involvement of PTL was recently reported, but the spermatic cord and glans penis were intact by surgical examination [ 18 ]. Also in our patient, no infiltration of the spermatic cord by surgical examination at initial high orchiectomy.…”

Risk Factors for Testicular Cancer: Environment, Genes and Infections—Is It All?

“…Nevertheless, testicular cancer is rare before age 15 [44]. Regarding testicular cancer in older men (>50 years), it has to be reported, however, that the most commonly occurring testicular malignancy is testicular lymphoma, often secondary to non-Hodgkin lymphoma, while the primary testicular lymphoma is rare and could have a different age range [45][46][47].…”

Epigenetic Factors and ncRNAs in Testicular Cancer

“…It is also clinically important to identify biomarkers that can predict the effectiveness of genotoxic drugs, so as to avoid exposing nonresponders to potentially harmful treatments. A study utilizing a whole-genome CRISPR/Cas9 gene knockout approach identified ASH2L, a core component of the H3K4 methyl transferase complex, as a protein necessary for bleomycin sensitivity in Hodgkin lymphoma [104]. ASH2L levels could potentially serve as a biomarker for predicting the response to genotoxic drugs in testicular cancer.…”

“…ASH2L levels could potentially serve as a biomarker for predicting the response to genotoxic drugs in testicular cancer. In cases where tumors express low levels of ASH2L, which may confer resistance to genotoxic treatment, the use of ATR or ATM inhibitors might be more effective, as data suggest that ASH2L knockdown does not affect sensitivity to these inhibitors [104].…”