Testicular lymphoma is associated with a high incidence of extranodal recurrence

BACKGROUND. Testicular lymphoma is a rare extranodal presentation of non-Ho dgkin lymphoma. The authors report long term follow-up information regardin g a group of patients with testicular lymphoma evaluated at the Mayo Clinic and describe the outcome with special attention to patterns of recurrence. METHODS. The medical records of patients with testicular lymphoma seen at t he Mayo Clinic between January 1970 and March 1993 were reviewed. Patients were included if they had evidence of testicular involvement at the time of diagnosis of lymphoma. Pathology specimens were reviewed for confirmation of diagnosis. RESULTS, Sixty-two patients with a diagnosis of testicular lymphoma were id entified. Their median age was 68 years, and 60 patients underwent orchiect omy as the initial therapeutic and diagnostic procedure. Most of patients ( 79%) had localized or regional disease at the time of presentation. Other t reatment modalities after diagnosis included radiotherapy (37%), combinatio n chemotherapy (37%), and combination chemotherapy and radiotherapy (16%). Although 88% of patients had no residual disease after primary treatment, 8 0% subsequently experienced disease recurrence. There was no significant di fference in the rate of recurrence, including Ann Arbor Stage I disease. Tr eatment did not appear to affect the recurrence rate. At a median follow-up of 2.7 years, 60% of patients had died of disease. Late recurrences were o bserved, and there appeared to be no plateau in the disease free survival c urve. In half (51%) of the patients with disease recurrence, only extranoda l locations were involved. Thirteen patients experienced recurrence in the central nervous system, 11 of whom had parenchymal lesions. In 8 of these 1 3 patients, the central nervous system was an isolated site of disease recu rrence. CONCLUSIONS. Testicular lymphoma is a unique and aggressive extranodal non- Hodgkin lymphoma. Better treatment strategies are needed to prevent recurre nces. The risk of extranodal recurrence is high, especially in the central nervous system. Cancer 2000;88:154-61. (C) 2000 American Cancer Society.