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Enhancing Tumor Content through Tumor Macrodissection

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Published on: February 12, 2022

Penile diffuse large B-cell lymphoma in a young man.

Ian Robertson¹, Jon Heald², Daniel Ding³

¹Internal Medicine, Walter Reed National Military Medical Center, Bethesda, Maryland, USA ianrobertson415@gmail.com.

BMJ Case Reports

|March 14, 2025

Summary

This case study details a rare instance of penile diffuse large B-cell lymphoma (DLBCL) in a young adult. The patient successfully responded to R-CHOP chemotherapy, avoiding radiation therapy.

Keywords:

Chemotherapy Urology

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Area of Science:

Hematology
Oncology
Urology

Background:

Penile diffuse large B-cell lymphoma (DLBCL) is an exceptionally rare extranodal non-Hodgkin lymphoma.
Primary penile DLBCL typically affects elderly men, with a median age of 69 years.

Purpose of the Study:

To report a unique case of stage IE penile DLBCL in a young active-duty service member.
To discuss the diagnosis and management of this rare condition in an atypical demographic.

Main Methods:

Case presentation of a young male diagnosed with stage IE penile DLBCL, germinal centre B-cell (GCB) subtype.
Treatment administered included four cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP).
Interim positron emission tomography (PET) scan guided the decision to omit radiation therapy.

Main Results:

The patient, significantly younger than the typical demographic, achieved a positive response to R-CHOP chemotherapy.
Radiation therapy was not administered due to the favorable PET scan results, indicating treatment efficacy.
The case highlights successful management of penile DLBCL in an unusual patient profile.

Conclusions:

Penile DLBCL, though rare, can occur in younger individuals, challenging typical epidemiological patterns.
R-CHOP chemotherapy is an effective treatment option for limited-stage penile DLBCL.
PET-guided treatment de-escalation may be feasible in select cases of penile DLBCL, sparing patients from radiation toxicity.