Non-Hodgkin's lymphoma originating in the spermatic cord

An otherwise healthy 57-year-old man was found to have an early stage, high-grade, non-Hodgkin's lymphoma (NHL) of the spermatic cord. A plan of treatment involving surgery, radiation therapy, combination chemotherapy, and central nervous system prophylaxis was recommended. He did not complete the recommended treatment plan, and subsequently returned with recurrent tumor in his brain. This case highlights the similarity of spermatic cord NHL to primary NHL of the testicle, and the propensity of both to progress or relapse in nodal and extranodal patterns.