#0915

Primary Testicular Lymphoblastic Lymphoma: A Case Report and Literature Review of Diagnosis and Staging Investigations, Treatment, and Prognosis

G. Mak^1,2, K. Chew³, D. Wood³, S. Mcgrath³, D. Lee³

¹University of New South Wales, School of Clinical Medicine, Sydney, Australia
²St George Hospital, Department of Urology, Kogarah, Australia
³St George Hospital, Urology, Kogarah, Australia

Introduction:

Lymphoblastic lymphoma (LBL) is a rare malignancy of precursor lymphoid cells, typically presenting with mediastinal or nodal disease. Isolated testicular involvement is exceptionally uncommon. Due to its rarity, there is limited guidance on diagnostic workup, staging, treatment, and follow-up. We present a case of bilateral primary testicular lymphoblastic lymphoma in an adult and review the current evidence on its management.

Material and methods:

A targeted literature review was conducted using PubMed and Google Scholar to identify reported cases of lymphoblastic lymphoma with primary or isolated testicular involvement, including both B-cell and T-cell subtypes. Data were extracted on presenting features, diagnostic approach, imaging, treatment regimens, and outcomes. These findings were synthesised with an illustrative case of adult bilateral testicular LBL to highlight diagnostic and therapeutic considerations.

Results:

Nine cases of localised primary testicular lymphoblastic lymphoma were identified, comprising two T-cell and seven B-cell subtypes. Presentation most commonly involved testicular swelling (n=7), with pain reported in five cases and constitutional symptoms in one. Eight cases were unilateral; only one, our case, demonstrated bilateral involvement. Ages ranged from 3 to 39 years, with five paediatric and four adult patients. Diagnosis and staging involved ultrasound (n=7), CT (n=7), bone marrow biopsy (all), lumbar puncture (n=6), and FDG-PET scan (n=3). Local control was achieved with orchidectomy in seven cases, including one bilateral orchidectomy (this case); one case was managed with biopsy alone and one did not specify local treatment. Radiotherapy to the contralateral testis was conducted in two cases. All patients received systemic and intrathecal chemotherapy using variable regimens based on Acute Lymphoblastic Leukaemia protocols, despite no confirmed CNS involvement. Follow-up duration ranged from 3 to 36 months. One patient experienced relapse at 3 months; all others remained disease-free during follow-up.