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Primary testicular lymphoma--A case report.

L Jaichand Singh1, S Bhagyabati Devi, T Arunkumar Singh

  • 1Department of Radiotherapy, Regional Institute of Medical Sciences, Imphal 795004.

Journal of the Indian Medical Association
|August 17, 2006
PubMed
Summary

A 45-year-old man with non-Hodgkin's lymphoma of the testis developed brain metastases seven years after initial treatment. Subsequent cranial radiation and intrathecal methotrexate led to a favorable response.

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Area of Science:

  • Oncology
  • Neurology
  • Medical Imaging

Background:

  • Primary testicular lymphoma is typically diagnosed in older individuals.
  • Non-Hodgkin's lymphoma of the testis requires multimodal treatment including chemotherapy and radiation.

Observation:

  • A 45-year-old male with primary testicular non-Hodgkin's lymphoma underwent orchiectomy, chemotherapy (cyclophosphamide, vincristine, adriamycin, prednisolone), and radiation therapy.
  • Seven years post-treatment, the patient presented with left facial nerve palsy and left hemiparesis.
  • Brain CT revealed multiple space-occupying lesions in both cerebral hemispheres.

Findings:

  • The patient's neurological deficits and brain lesions were indicative of central nervous system (CNS) metastases.
  • Treatment with cranial radiation therapy and intrathecal methotrexate resulted in a favorable clinical response.

Implications:

  • This case highlights the potential for late CNS recurrence in testicular lymphoma patients.
  • It underscores the importance of long-term surveillance for neurological complications.
  • Effective management strategies for CNS involvement include radiation and intrathecal chemotherapy.

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