518 Testicular Mass: A Rare Presentation of Richter’s Syndrome

Abstract A 72-year-old male patient who presented with a painless right sided scrotal swelling for few months. History of stage Chronic Lymphocytic Leukemia (CLL) since 2015- under surveillance by hematology team. On examination; 10 X cm hard non-tender right-sided mass, normal left testicle, no peripheral lymphadenopathy or organomegaly. WBC count = 17.5 × 109 /L neutrophils 4.39 & lymphocytes 11.16 /L. Testicular tumour marker; within CT chest, abdomen, and pelvis (CAP); some borderline enlarged para-aortic aorto-caval lymph nodes unremarkable abdominal viscera. Right inguinal orchiectomy Histopathology immunohistochemistry profile were consistent high-grade Richter’s transformation to diffuse large B cell lymphoma. MDT plan hematologist: 6 cycles R-CHOP IV as well intrathecal Methotraxate CNS prophylaxis. Patient was given the option testicular radiotherapy vs orchidectomy he opted orchidectomy. After more than 24 months follow up, had relapse. syndrome (RS) is CLL an aggressive form lymphoma mostly represented (DLBCL) in 2 -10% patients. RS clinically characterized development symptoms (fever, night sweats weight loss), rapid clinical deterioration increase size /or splenomegaly. commonly arises bone marrow disseminates other organs. Presenting this case, quite rare our represents 4th case reported literature.