Primary penile diffuse large B cell lymphoma treated by local excision followed by rituximab-containing chemotherapy

Primary penile lymphoma is rarely observed in cases of extranodal malignant lymphoma. Owing principally to its rarity, no definite treatment modality has been established. We report the case of a 42-year-old man who presented with hematuria and a painless palpable mass on the penis which had persisted for 2 months. A 1.5 x 1.4 cm round mass was detected in the shaft of the penis. Histopathological examination of the excisional biopsy revealed CD20+ diffuse large B cell lymphoma. The patient was classified as having a stage I(AE) lymphoma. Because radiation often causes considerable early morbidity and later loss of function of the penis, 6 cycles of combination chemotherapy (cyclophosphamide, doxorubicin, vincristine and prednisolone) with rituximab were administered at 3-week intervals. After treatment, the patient showed a complete response and has maintained this status for the past 7 months. Multiple options, such as surgical amputation, radiotherapy and chemotherapy, are available for treatment of this condition. However, in order to minimize treatment-related morbidity and to maintain quality of life after treatment, combination chemotherapy including rituximab could be considered the treatment of choice after local excision.