Rare entitity primary testicular lymphoma: a single-center analysis

Introduction: Primary testicular lymphoma (PTL) is a rare disease, accounting for <5% of all testicular malignancies and 1–2% of non-Hodgkin lymphoma cases. Diffuse large B-cell lymphoma (DLBCL) is the most common histological diagnosis. The literature data concerning PTL is scarce and based mainly on small series or retrospective studies. Methods and results: In this paper, we present six patients with DLBCL-PTL who were treated in the Department of Hematology and Bone Marrow Transplantation at Poznan University of Medical Science, Poland between 2006 and 2022. All the patients obtained complete remission (CR) after six cycles of R-CHOP-21 (cyclophosphamide, doxorubicin, vincristine and rituximab on day 1, and prednisolone on days 1–5, administered every 21 days for a total of eight cycles) as immunochemotherapy. Five of them additionally received prophylaxis of central nervous system involvement with intrathecal methotrexate/arabinoside cytosine. One patient received scrotal radiotherapy, and in another one radiotherapy is planned. Relapse was confirmed in one patient after 72 months in the contralateral testis, and the patient was successfully retreated. After a median follow-up of 146 (range 5–196) months, all patients remain alive and in CR. Conclusion: Despite all interpretative limitations, the current standard DLBCL-PTL therapy seems to be six courses of CHOP-R-21 combined with intrathecal metothrexate and scrotal irradiation.