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Journal of the National Medical Association logoLink to Journal of the National Medical Association
. 2007 Nov;99(11):1277–1282.

Primary testicular lymphoma.

Filiz Vural 1, Seckin Cagirgan 1, Guray Saydam 1, Mine Hekimgil 1, Nur Akad Soyer 1, Murat Tombuloglu 1
PMCID: PMC2574328  PMID: 18020104

Abstract

We evaluated clinical features, management and survival of 12 patients with primary testicular non-Hodgkin's lymphoma presented to our hematology unit between January 1992 and July 2006, retrospectively. The median age of patients was 47 years at presentation (range 29-78 years) and > 80% of them were < 50 years old. In the majority of cases, orchidectomy was performed as diagnostic and first-line therapeutic procedures. Dominant histological subtype was diffuse large B-cell non-Hodgkin's lymphoma. Seven patients out of 12 (58%) were Ann Arbor stages I and II, and the remaining five patients (42%) were stages III and IV. All the patients received doxorubicin-based chemotherapy and achieved complete remission. The addition of rituximab and central nervous system prophylaxis with intrathecal combined chemotherapy containing methotrexate, cytarabine and dexametasone were applied to three patients who were recently admitted. The rate of relapse was 8% and progression-free survival (PFS) at 10 years was 88%. Median duration of response was 84 months (range 14-173 months), median 97.5 months of follow-up. All patients are alive and in case remission. Because of the spreading nature and relapse probability at different sites, including central nervous system and contralateral testis, systemic treatment with doxorubicin-based chemotherapy with or without prophylaxis for contralateral testis and the central nervous system seems to improve the outcome of primary testicular lymphoma.

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Selected References

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  1. Anbazhagan R., Gusterson B. A. Prenatal factors may influence predisposition to breast cancer. Eur J Cancer. 1994;30A(1):1–3. doi: 10.1016/s0959-8049(05)80006-1. [DOI] [PubMed] [Google Scholar]
  2. Avilés Agustin, Neri Natividad, Huerta-Guzmán Judith, Pérez Felipe, Fernández Raúl. Testicular lymphoma: organ-specific treatment did not improve outcome. Oncology. 2004;67(3-4):211–214. doi: 10.1159/000081319. [DOI] [PubMed] [Google Scholar]
  3. Baldetorp L. A., Brunkvall J., Cavallin-Ståhl E., Henrikson H., Holm E., Olsson A. M., Akerman M. Malignant lymphoma of the testis. Br J Urol. 1984 Oct;56(5):525–530. doi: 10.1111/j.1464-410x.1984.tb06271.x. [DOI] [PubMed] [Google Scholar]
  4. Buskirk S. J., Evans R. G., Banks P. M., O'Connell M. J., Earle J. D. Primary lymphoma of the testis. Int J Radiat Oncol Biol Phys. 1982 Oct;8(10):1699–1703. doi: 10.1016/0360-3016(82)90289-9. [DOI] [PubMed] [Google Scholar]
  5. Carbone P. P., Kaplan H. S., Musshoff K., Smithers D. W., Tubiana M. Report of the Committee on Hodgkin's Disease Staging Classification. Cancer Res. 1971 Nov;31(11):1860–1861. [PubMed] [Google Scholar]
  6. Ciatto S., Cionini L. Malignant lymphoma of the testis. Acta Radiol Oncol Radiat Phys Biol. 1979;18(6):572–576. doi: 10.3109/02841867909129086. [DOI] [PubMed] [Google Scholar]
  7. Connors J. M., Klimo P., Voss N., Fairey R. N., Jackson S. Testicular lymphoma: improved outcome with early brief chemotherapy. J Clin Oncol. 1988 May;6(5):776–781. doi: 10.1200/JCO.1988.6.5.776. [DOI] [PubMed] [Google Scholar]
  8. Crellin A. M., Hudson B. V., Bennett M. H., Harland S., Hudson G. V. Non-Hodgkin's lymphoma of the testis. Radiother Oncol. 1993 May;27(2):99–106. doi: 10.1016/0167-8140(93)90128-u. [DOI] [PubMed] [Google Scholar]
  9. Darby Suzanne, Hancock Barry W. Localised non-Hodgkin lymphoma of the testis: the Sheffield Lymphoma Group experience. Int J Oncol. 2005 Apr;26(4):1093–1099. [PubMed] [Google Scholar]
  10. Duncan P. R., Checa F., Gowing N. F., McElwain T. J., Peckham M. J. Extranodal non-Hodgkin's lymphoma presenting in the testicle: a clinical and pathologic study of 24 cases. Cancer. 1980 Apr 1;45(7):1578–1584. doi: 10.1002/1097-0142(19800401)45:7<1578::aid-cncr2820450711>3.0.co;2-k. [DOI] [PubMed] [Google Scholar]
  11. Fonseca R., Habermann T. M., Colgan J. P., O'Neill B. P., White W. L., Witzig T. E., Egan K. S., Martenson J. A., Burgart L. J., Inwards D. J. Testicular lymphoma is associated with a high incidence of extranodal recurrence. Cancer. 2000 Jan 1;88(1):154–161. doi: 10.1002/(sici)1097-0142(20000101)88:1<154::aid-cncr21>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  12. Gospodarowicz MK, Sutcliffe SB. The Extranodal Lymphomas. Semin Radiat Oncol. 1995 Oct;5(4):281–300. doi: 10.1054/SRAO00500281. [DOI] [PubMed] [Google Scholar]
  13. Hasselblom Sverker, Ridell Börje, Wedel Hans, Norrby Klas, Sender Baum Monica, Ekman Tor. Testicular lymphoma--a retrospective, population-based, clinical and immunohistochemical study. Acta Oncol. 2004;43(8):758–765. doi: 10.1080/02841860410002851. [DOI] [PubMed] [Google Scholar]
  14. Hill Quentin A., Owen Roger G. CNS prophylaxis in lymphoma: who to target and what therapy to use. Blood Rev. 2006 Aug 1;20(6):319–332. doi: 10.1016/j.blre.2006.02.001. [DOI] [PubMed] [Google Scholar]
  15. Lagrange J. L., Ramaioli A., Theodore C. H., Terrier-Lacombe M. J., Beckendorf V., Biron P., Chevreau C. H., Chinet-Charrot P., Dumont J., Delobel-Deroide A. Non-Hodgkin's lymphoma of the testis: a retrospective study of 84 patients treated in the French anticancer centres. Ann Oncol. 2001 Sep;12(9):1313–1319. doi: 10.1023/a:1012224123385. [DOI] [PubMed] [Google Scholar]
  16. Liang R., Chiu E., Loke S. L. An analysis of 12 cases of non-Hodgkin's lymphomas involving the testis. Ann Oncol. 1990 Sep;1(5):383–383. doi: 10.1093/oxfordjournals.annonc.a057783. [DOI] [PubMed] [Google Scholar]
  17. Martenson J. A., Jr, Buskirk S. J., Ilstrup D. M., Banks P. M., Evans R. G., Colgan J. P., Earle J. D. Patterns of failure in primary testicular non-Hodgkin's lymphoma. J Clin Oncol. 1988 Feb;6(2):297–302. doi: 10.1200/JCO.1988.6.2.297. [DOI] [PubMed] [Google Scholar]
  18. Pectasides D., Economopoulos T., Kouvatseas G., Antoniou A., Zoumbos Z., Aravantinos G., Tsatalas C., Halikia A., Nikolaides C., Kiamouris C. Anthracycline-based chemotherapy of primary non-Hodgkin's lymphoma of the testis: the hellenic cooperative oncology group experience. Oncology. 2000 May;58(4):286–292. doi: 10.1159/000012114. [DOI] [PubMed] [Google Scholar]
  19. Read G. Lymphomas of the testis-results of treatment 1960-77. Clin Radiol. 1981 Nov;32(6):687–692. doi: 10.1016/s0009-9260(81)80340-6. [DOI] [PubMed] [Google Scholar]
  20. Sasai K., Yamabe H., Tsutsui K., Dodo Y., Ishigaki T., Shibamoto Y., Hiraoka M. Primary testicular non-Hodgkin's lymphoma: a clinical study and review of the literature. Am J Clin Oncol. 1997 Feb;20(1):59–62. doi: 10.1097/00000421-199702000-00013. [DOI] [PubMed] [Google Scholar]
  21. Seymour J. F., Solomon B., Wolf M. M., Janusczewicz E. H., Wirth A., Prince H. M. Primary large-cell non-Hodgkin's lymphoma of the testis: a retrospective analysis of patterns of failure and prognostic factors. Clin Lymphoma. 2001 Sep;2(2):109–115. doi: 10.3816/clm.2001.n.016. [DOI] [PubMed] [Google Scholar]
  22. Shahab N., Doll D. C. Testicular lymphoma. Semin Oncol. 1999 Jun;26(3):259–269. [PubMed] [Google Scholar]
  23. Thomas Deborah A., Faderl Stefan, O'Brien Susan, Bueso-Ramos Carlos, Cortes Jorge, Garcia-Manero Guillermo, Giles Francis J., Verstovsek Srdan, Wierda William G., Pierce Sherry A. Chemoimmunotherapy with hyper-CVAD plus rituximab for the treatment of adult Burkitt and Burkitt-type lymphoma or acute lymphoblastic leukemia. Cancer. 2006 Apr 1;106(7):1569–1580. doi: 10.1002/cncr.21776. [DOI] [PubMed] [Google Scholar]
  24. Tondini C., Ferreri A. J., Siracusano L., Valagussa P., Giardini R., Rampinelli I., Bonadonna G. Diffuse large-cell lymphoma of the testis. J Clin Oncol. 1999 Sep;17(9):2854–2858. doi: 10.1200/JCO.1999.17.9.2854. [DOI] [PubMed] [Google Scholar]
  25. Touroutoglou N., Dimopoulos M. A., Younes A., Hess M., Pugh W., Cox J., Cabanillas F., Sarris A. H. Testicular lymphoma: late relapses and poor outcome despite doxorubicin-based therapy. J Clin Oncol. 1995 Jun;13(6):1361–1367. doi: 10.1200/JCO.1995.13.6.1361. [DOI] [PubMed] [Google Scholar]
  26. Turner R. R., Colby T. V., MacKintosh F. R. Testicular lymphomas: a clinicopathologic study of 35 cases. Cancer. 1981 Nov 1;48(9):2095–2102. doi: 10.1002/1097-0142(19811101)48:9<2095::aid-cncr2820480930>3.0.co;2-r. [DOI] [PubMed] [Google Scholar]
  27. Visco C., Medeiros L. J., Mesina O. M., Rodriguez M. A., Hagemeister F. B., McLaughlin P., Romaguera J. E., Cabanillas F., Sarris A. H. Non-Hodgkin's lymphoma affecting the testis: is it curable with doxorubicin-based therapy? Clin Lymphoma. 2001 Jun;2(1):40–46. doi: 10.3816/clm.2001.n.010. [DOI] [PubMed] [Google Scholar]
  28. Zietman A. L., Coen J. J., Ferry J. A., Scully R. E., Kaufman D. S., McGovern F. G. The management and outcome of stage IAE nonHodgkin's lymphoma of the testis. J Urol. 1996 Mar;155(3):943–946. [PubMed] [Google Scholar]
  29. Zucca E., Conconi A., Mughal T. I., Sarris A. H., Seymour J. F., Vitolo U., Klasa R., Ozsahin M., Mead G. M., Gianni M. A. Patterns of outcome and prognostic factors in primary large-cell lymphoma of the testis in a survey by the International Extranodal Lymphoma Study Group. J Clin Oncol. 2003 Jan 1;21(1):20–27. doi: 10.1200/JCO.2003.11.141. [DOI] [PubMed] [Google Scholar]
  30. van der Maazen R. W., Noordijk E. M., Thomas J., Raemaekers J. M., Meerwaldt J. H. Combined modality treatment is the treatment of choice for stage I/IE intermediate and high grade non-Hodgkin's lymphomas. Radiother Oncol. 1998 Oct;49(1):1–7. doi: 10.1016/s0167-8140(98)00066-8. [DOI] [PubMed] [Google Scholar]

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