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. 2023 Jun;17(2):130-134.
doi: 10.1097/CU9.0000000000000137. Epub 2022 Aug 31.

Primary testicular lymphoma: Clinical characteristics and oncological outcomes

Alberto Artiles Medina  1 , Javier Lorca Álvaro  1 , Irene Carretero Del Barrio  2 , Inés Laso García  1 , Mónica García Cosío  2 , Marina Mata Alcaraz  1 , Manuel Hevia Palacios  1 , Victoria Gómez Dos Santos  1 , Francisco Javier Burgos Revilla  1
Affiliations

Primary testicular lymphoma: Clinical characteristics and oncological outcomes

Alberto Artiles Medina et al. Curr Urol. 2023 Jun.

Abstract

Background: Primary testicular lymphoma (PTL) is a rare testicular malignancy, despite being considered the most common testicular tumor in patients older than 60 years. Primary testicular lymphoma represents only 1%-9% of testicular neoplasms. Few studies have been published regarding its clinical features and management. This study aimed to analyze the clinical characteristics and outcomes of PTL.

Materials and methods: Orchiectomy specimens of 15 patients with PTL diagnosed during 2000-2020 at our institution were retrospectively studied. We collected information on demographic data, clinical features, management aspects, and outcomes of PTL treatment. Kaplan-Meier survival curves and Cox regression analyses were used to study survival.

Results: The median patient age was 69 years (interquartile range, 61-72 years). The most prevalent clinical presentation was testicular swelling (80%), and only 13.33% of the patients presented with systemic symptoms. Central nervous system involvement was detected in 6 patients (40%). Of the 15 patients, 5 (33.33%) had stage IE and 10 (66.67%) had stage IVE lymphoma. Diffuse large B-cell lymphoma was the most common histological subtype. Twelve patients (80%) received chemotherapy. During follow-up, 4 patients (26.67%) relapsed. The recurrence rate in the contralateral testicle was 13.33%. The median cancer-specific survival was 21.58 months (95% confidence interval, 0-43.95 months). Univariate Cox regression analysis showed that central nervous system involvement and International Prognostic Index score were significantly associated with shorter cancer-specific survival.

Conclusions: Primary testicular lymphoma has a high relapse rate and poor prognosis. Management strategies typically include radical orchiectomy and systemic chemotherapy. Central nervous system involvement and International Prognostic Index scores were associated with lymphoma-specific survival.

Keywords: Non-Hodgkin lymphoma; Primary testicular lymphoma; Prognosis; Testicular neoplasms; Testis.

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Conflict of interest statement

No conflict of interest has been declared by the authors.

Figures

Figure 1
Figure 1
(A) Photograph of a radical orchiectomy specimen revealing an enlarged testis and a nodule in the spermatic cord. (B) Hematoxylin and eosin staining showing diffuse proliferation of large neoplastic lymphoid cells. (C) Tumor cells showing positivity for the expression of CD20.
Figure 2
Figure 2
Kaplan-Meier plot for cumulative cancer-specific survival after primary testicular lymphoma diagnosis.
Figure 3
Figure 3
Kaplan-Meier plot for cumulative overall survival after primary testicular lymphoma diagnosis.
See this image and copyright information in PMC

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