Testicular relapse in childhood leukemia

Five patients in bone marrow remission from childhood leukemia who subsequently had relapse in the testicle are reviewed. Clinically, recurrence of disease is often limited to this site. In spite of satisfactory local control with radiotherapy, further systemic progression generally occurs within 1 year. Previous studies suggest that patients who are in clinical remission harbor tumor in multiple occult "sanctuaries." Testicular leukemia reflects this uncontrolled extramedullary disease, and studies in optimal management of the generalized process are needed.