Abstract
Background:
A 45-year-old man underwent a right orchiectomy for a rapidly growing testicular mass. After histologic and imaging examinations the patient was diagnosed with stage I (T1N0M0) seminoma. Approximately 2 months after surgery the patient began to complain of abdominal pain and a CT scan revealed a bulky retroperitoneal mass. The patient did not receive the planned prophylactic radiotherapy and was treated with combined cisplatin, etoposide and bleomycin chemotherapy; after the completion of this treatment he achieved complete remission. Three years later, and while still undergoing follow-up, the patient developed multiple neurological motor deficits.
Investigations:
Brain MRI and CT-guided biopsy.
Diagnosis:
Diffuse large B-cell lymphoma of the testis, relapsing in the central nervous system.
Management:
High-dose methotrexate alone or in combination with high-dose cytarabine.
MeSH terms
-
Antigens, CD20 / metabolism
-
Antineoplastic Combined Chemotherapy Protocols / therapeutic use*
-
Bleomycin / administration & dosage
-
Brain / diagnostic imaging
-
Cisplatin / administration & dosage
-
Cytarabine / administration & dosage
-
Diagnosis, Differential
-
Etoposide / administration & dosage
-
Fatal Outcome
-
Humans
-
Immunohistochemistry
-
Interferon Regulatory Factors / metabolism
-
Lymphoma, Large B-Cell, Diffuse / diagnosis*
-
Lymphoma, Large B-Cell, Diffuse / drug therapy
-
Lymphoma, Large B-Cell, Diffuse / pathology
-
Male
-
Methotrexate / administration & dosage
-
Middle Aged
-
Orchiectomy
-
Radiography
-
Recurrence
-
Remission Induction
-
Seminoma / diagnosis
-
Seminoma / drug therapy*
-
Seminoma / pathology
-
Seminoma / surgery
-
Testicular Neoplasms / diagnosis*
-
Testicular Neoplasms / drug therapy*
-
Testicular Neoplasms / pathology
-
Testicular Neoplasms / surgery
Substances
-
Antigens, CD20
-
Interferon Regulatory Factors
-
interferon regulatory factor-4
-
Cytarabine
-
Bleomycin
-
Etoposide
-
Cisplatin
-
Methotrexate