Clinical case:

An 88-year-old male with a clinical and ultrasound diagnosis of a left hydrocele, treated with radical orchiectomy with an immunohistochemical report of diffuse large cell immunophenotype B non-Hodgkin's lymphoma under current chemotherapy-based treatment.

Relevance:

In Mexico, primary testicular lymphoma is rare, in our institution it is the first reported case. In 43% of cases, it is associated with benign pathology such as hydrocele or epididymo-orchitis, which makes it difficult to suspect a malignant etiology, taking into account that timely diagnosis and prompt treatment is of vital importance for prognosis.

Clinical implications:

This rare entity requires a high index of clinical suspicion for testicular pathology in the context of patients over 50 years of age, with or without consumptive symptoms. It is considered an aggressive disease with a poor prognosis due to its high relapse rate to extranodal sites and the central nervous system.

Discussion and conclusion:

Primary testicular lymphoma is a rare neoplasm with an annual incidence of 0.26 cases per 100,000 person-years, the mean age of presentation is 60 years, it presents unspecific clinical expression with definitive diagnosis by immunohistochemistry. Multimodal treatment has shown an improvement in the prognosis of this entity.

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