Lymphomas are the most common testicular malignancy in elderly male with DLBCL being most common subtype. Less common histological subtypes include Burkitt lymphoma and follicular lymphoma. Testicular DLBCL has poor treatment outcomes than nodal DLBCL due to high risk of relapse in opposite testes, CNS and other sites.
From the database, patients diagnosed as testicular lymphoma over a period of five years from January 2013 to December 2017 at department of Madras Medical College, Chennai were retrieved and analysed.
8 patients were found to have testicular lymphoma with all being DLBCL subtype. Median age of diagnosis was 61 years. 25% (n=2) patients had B symptoms. 4 patients had stage IE, 2 patients had stage II and 2 patients had stage IV. LDH was elevated in stage IV patients. None developed contralateral testicular lymphoma. All patients underwent high inguinal orchidectomy of involved testis. 3 patients had removal of opposite testis after completion of whole treatment and 5 patients received radiotherapy of 30Gy to contralateral testes. All patients received R-CHOP once in 21 days for 6 cycles along with intrathecal methotrexate of 12.5mg except 1 patient receiving 4 cycles only due to poor PS. 2 patients had febrile neutropenia during chemotherapy and got recovered. 2.5 year DFS was 62.5%(n=5) and 2.5 year OS was 75%(n=6) with a median follow up period of 56 months.
Due to rarity of this tumour standard treatment regimen remains unknown. R-CHOP gives treatment outcomes comparable to the literature.
Sivasubramaniam.
Has not received any funding.
All authors have declared no conflicts of interest.