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The impact of histopathologic diagnosis on the proper management of testis neoplasms

Nature Clinical Practice Oncology volume 5, pages 619–622 (2008)Cite this article

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.

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Figure 1: Diffuse large B-cell lymphoma of the brain and testis.
Figure 2: Patterns of relapse in testicular lymphoma.

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Author information

Authors and Affiliations

  1. G Ponti is a Postdoctoral Fellow and E Zucca is a Medical Oncologist and Head of the Lymphoma Unit at the Oncology Institute of Southern Switzerland, Bellinzona ,

    Giovanni Ponti & Emanuele Zucca

  2. L Mazzucchelli is Head of the Cantonal Institute of Pathology, Locarno, Switzerland.,

    Luca Mazzucchelli

  3. M Ponzoni is Coordinator of the Functional Unit of Hematopathology at the Department of Pathology, and M Foppoli is a Senior Hematologist at the Internal Medicine Unit of the Department of Oncology, AJM Ferreri is Coordinator of the Unit of Lymphoid Malignancies and Vice Director of the Medical Oncology Unit, all at the San Raffaele H Scientific Institute, Milan, Italy.,

    Maurilio Ponzoni, Andrés JM Ferreri & Marco Foppoli

Authors
  1. Giovanni Ponti
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  2. Maurilio Ponzoni
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  3. Andrés JM Ferreri
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  4. Marco Foppoli
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  5. Luca Mazzucchelli
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  6. Emanuele Zucca
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Corresponding author

Correspondence to Emanuele Zucca.

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Competing interests

The authors declare no competing financial interests.

Supplementary information

Supplementary Box 1

WHO histological classification of testicular neoplasms. (DOC 32 kb)

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Ponti, G., Ponzoni, M., Ferreri, A. et al. The impact of histopathologic diagnosis on the proper management of testis neoplasms. Nat Rev Clin Oncol 5, 619–622 (2008). https://doi.org/10.1038/ncponc1218

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