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


METHODS
Brain MRI and CT-guided biopsy.


METHODS
Diffuse large B-cell lymphoma of the testis, relapsing in the central nervous system.


RESULTS
High-dose methotrexate alone or in combination with high-dose cytarabine.
Ponti
Giovanni
G
Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
Ponzoni
Maurilio
M
Ferreri
Andrés Jm
AJ
Foppoli
Marco
M
Mazzucchelli
Luca
L
Zucca
Emanuele
E
D018951:Antigens, CD20 / Q000378:metabolism; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D001761:Bleomycin / Q000008:administration & dosage; D001921:Brain / Q000000981:diagnostic imaging; D002945:Cisplatin / Q000008:administration & dosage; D003561:Cytarabine / Q000008:administration & dosage; D003937:Diagnosis, Differential; D005047:Etoposide / Q000008:administration & dosage; D017809:Fatal Outcome; D006801:Humans; D007150:Immunohistochemistry; D050835:Interferon Regulatory Factors / Q000378:metabolism; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D008727:Methotrexate / Q000008:administration & dosage; D008875:Middle Aged; D009919:Orchiectomy; D011859:Radiography; D012008:Recurrence; D012074:Remission Induction; D018239:Seminoma / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D013736:Testicular Neoplasms / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology / Q000601:surgery; D000099218:Interferon Regulatory Factor-4
D018951:Antigens, CD20; D001761:Bleomycin; D002945:Cisplatin; D003561:Cytarabine; D005047:Etoposide; D050835:Interferon Regulatory Factors; D008727:Methotrexate; D000099218:Interferon Regulatory Factor-4