Primary Testicular Lymphoma: Single Center Experience

Area of Science:

• Hematology
• Oncology
• Urologic Oncology

Background:

• Primary testicular lymphoma (PTL) is a rare, aggressive non-Hodgkin's lymphoma, most commonly diffuse large B-cell lymphoma (DLBCL).
• Standard treatment involves orchiectomy, chemotherapy, central nervous system (CNS) prophylaxis, and contralateral testis radiation.
• Relapse can occur years after remission, highlighting the importance of treating immune sanctuary sites like the CNS and contralateral testis.

Purpose of the Study:

• To characterize the clinical presentation, treatment, and outcomes of patients with PTL.
• To add to the limited existing literature on PTL management and outcomes.
• To describe the experience with a specific treatment regimen including R-CHOP, intrathecal methotrexate, and contralateral testis irradiation.

Main Methods:

• A descriptive retrospective study of twelve PTL patients treated between 2010-2021.
• Collected demographic data, prognostic factors, treatment regimens, and relapse sites.
• Calculated mean progression-free survival (PFS) to evaluate treatment effectiveness.

Main Results:

• Eighty-three percent of patients (10/12) had ABC PTL-DLBCL, with a median age of 67.
• Most patients (66.66%) were African American and presented with elevated LDH and a left testicular mass.
• The majority received R-CHOP chemotherapy, intrathecal methotrexate (IT-MTX), and contralateral testis radiation; 25% relapsed with a median time to relapse of 8 months.

Conclusions:

• The study provides valuable data on PTL management, supporting the use of R-CHOP, IT-MTX, and contralateral testis irradiation.
• This approach resulted in a mean PFS of 50.417 months.
• Findings contribute to the limited body of knowledge regarding PTL treatment and outcomes.