Radiotherapy for stage IAE non-Hodgkin' s lymphoma of the testicle- a case report

Abstract

Background. The aim of this report is to present the irradiation technique applied to a patient with primary testicular non-Hodgkin's (NHL) lymphoma stage IEA, histologically CD20 positive NHL - diffuse follicular center cell (FCC) lymphoma grade Ill. Since primary NHLs of the testis are rather rare, no uniform radiotherapy approach to their treatment has been developed to date. Testicular NHLs are relatively often of ag~ gressive biological characteristics, so that the disease relapse is not uncommon even in patients in an early stage of the disease (stage I and ll), who received seemingly optimal therapy (orchiectomy of the diseased testicle, polychemotherapy and irradiation).

Case report. In this report the applied radiation treatment field is shown. The disease was diagnosed in June 2001 after the inguinal orchiectomy. Afterwards, the patient received 6 courses of polychemotherapy (CHOP) plus intrathecal methotrexate therapy. The irradiation was conducted with one direct 6 megavolt (MV) energy photon beam. The irradiation field encompassed the contralateral testicle (scrotum) and inguina-femora/lymph nodes. The radiotherapy dose was 30 Gy applied in 15 fractions calculated at the depth of 4 cm. The radiotherapy finished in December 2001. The patient has regular check-ups (last in May 2003) and has been in remission since then.

Conclusions. Relapse sites are quite often extranodal, not in the regional lymph nodes. Therefore, considering the radiation treatment fields there are no definitive recommendations.