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Extranodal Male Genital Involvement With Diffuse Large B-Cell Lymphoma
James J Fradin1, Kavanya Feustel2, Mehdi Hamadani2
1Division of Internal Medicine, Medical College of Wisconsin, Milwaukee, Wisconsin, USA, mcw.edu.
Case Reports in Hematology
|May 22, 2026
Summary
Primary penile diffuse large B-cell lymphoma (DLBCL) is rare and difficult to diagnose. A case report details successful treatment of advanced penile DLBCL in an elderly patient using a modified regimen including polatuzumab vedotin.
Area of Science:
- Oncology
- Hematology
- Rare Cancers
Background:
- Primary penile diffuse large B-cell lymphoma (DLBCL) is an exceptionally rare extranodal lymphoma.
- Diagnosis can be challenging due to nonspecific symptoms, potentially leading to delayed treatment.
Purpose of the Study:
- To report a case of advanced penile DLBCL in an elderly patient.
- To review existing literature on penile DLBCL presentation and treatment.
- To highlight the efficacy of novel agents in treating frail patients with advanced disease.
Main Methods:
- Case report of an 84-year-old male with Stage IVB activated B-cell type DLBCL.
- Treatment with dose-reduced rituximab, cyclophosphamide, doxorubicin, prednisone, and polatuzumab vedotin (modified R-mini-CHOP).
- Literature review of previously reported penile DLBCL cases.
Main Results:
- The patient achieved a partial metabolic response with negative minimal residual disease despite advanced-stage disease.
- Literature review identified patterns in penile DLBCL presentation and treatment strategies.
- Polatuzumab vedotin demonstrated potential in treating elderly/frail patients with advanced penile DLBCL.
Conclusions:
- Penile lesions require a broad differential diagnosis to ensure timely and appropriate treatment.
- Novel therapeutic agents like polatuzumab vedotin offer promising options for elderly or frail patients with advanced penile DLBCL.
- This case underscores the importance of considering rare presentations of lymphoma and adapting treatment regimens for vulnerable populations.
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