(UroToday.com) Testicular cancer is the most common solid malignancy affecting males between the ages of 15 and 35, although it accounts for only 1 percent of all cancers in men. Ms. Dunn began her lecture by presenting a case study of a 65 yo male who was diagnosed with Gleason 3+4 adenocarcinoma of the prostate who underwent a radical prostatectomy. He subsequently was diagnosed with a hypervascular 2.6 cm right testicular mass with an additional small 0.3 cm nodule superiorly. It was felt to be highly suspicious of a testicular neoplasm. Orchiectomy was performed and pathology indicated diffuse large B-cell lymphoma (DLBCL).
Primary testicular lymphoma is a rare and aggressive form of extranodal non-Hodgkin’s lymphoma (NHL). A common histologic subtype of NHL is diffuse large B-cell lymphoma (DLBCL) which accounts for 30% of patients with NHL. It is the most common malignant testicular tumor in men > 60 yrs. and accounts for approximately 1% of lymphomas overall. Relapses can occur in the CNS, skin, contralateral testis, and the pleura. Recommended treatment is orchiectomy. Ms. Dunn also reviewed the use of 6 cycles of five chemotherapeutic drugs: R-CHOP — rituximab (Rituxan)-monoclonal antibody, cyclophosphamide-alkylating agent, doxorubicin hydrochloride (anthracycline), vincristine-(Oncovin, Vincasar PFS) vinca alkaloid and prednisone. Men may also receive intrathecal or high-dose systemic methotrexate for CNS prophylaxis and scrotal radiation therapy to prevent contralateral testis recurrence.
Presented by: Mary W. Dunn, MSN, RN, OCN®, NP‐C
Written by: Diane Newman, DNP, ANP-BC, Adjunct Professor of Urology in Surgery, Perelman School of Medicine, University of Pennsylvania and Co-Director of the Penn Center for Continence and Pelvic Health