Primary lymphoma of the testis in remission for more than ten years: a case report.

BACKGROUND Primary testicular lymphoma is a unique, rare and aggressive extra nodal non-Hodgkins Lymphoma (NHL). It is the most common testicular tumour in males between 60 and 80 years old OBJECTIVE To report a case of primary testicular lymphoma in a young man who has done very well on surgery and chemotherapy. METHODS The patient a Nigerian male civil servant who was single and aged 31 years presented to us with a history of a progressive painful right scrotal swelling of two years duration and associated painful right groin swelling for one year. A working diagnosis of right hydrocele with differential diagnosis of lymphangioma was made. Investigations were essentially normal and patient was scheduled for hydrocelectomy but findings at operations were different. RESULTS At surgery, there was grossly enlarged hard right testis with thickened spermatic cord. Right radical inguinal orchidectomy with excision of the right spermatic cord and a regional lymph node was carried out. Histology revealed intermediate grade nodular NHL of the right testis. He was treated with systemic combination chemotherapy and has since been in complete remission for over 10 years. CONCLUSION Primary testicular lymphoma is a rare and unique neoplasm of the testis and is most commonly seen in men over the age of 60, but should be considered in the differential diagnosis of testicular tumours in younger age groups. It is curable in early stage with appropriate multimodalities of management.