TESTICULAR-TUMOR AND THE ACQUIRED-IMMUNODEFICIENCY-SYNDROME

Immunocompromised patients, particularly those suffering from the acqu ired immunodeficiency syndrome (AIDS), present an increased risk of tu moral pathology. From the observation of a testicular lymphoma associa ted with Epstein-Barr virus in a HIV+ patient, we review 19 cases of t esticular tumor in HIV+ patients previously published in the literatur e. These tumors are either lymphomas (4 cases) or germ cell tumors (15 cases). Their diagnosis was not difficult, although in the first stag es enlarged and painful testicles are often wrongly identified as orch iepididymitis and treated as such. Therapy management proves to be del icate as a result of the significant tumor spread seen in these patien ts with dysfunctional immune systems. Regarding lymphomas, a low-dose multiagent chemotherapy with intrathecal chemotherapy was recommended by Levine. Concerning germ cell tumors, Wilson prefers an instant aggr essive treatment with retroperitoneal lymphadenectomy (whether or not combined with chemotherapy) to avoid the risk of recurrence. In fact, tumor relapses will be difficult to control in the progressive stages of immunodeficiency syndrome.