RESUMEN
BACKGROUND: Testicular lymphoma is an aggressive, extranodal, non-Hodgkin lymphoma, accounting for less than 10% of all testicular neoplasms and less than 1% of lymphoproliferative malignancies. A paraneoplastic syndrome has been reported and may precede diagnosis of testicular cancer. A delay in diagnosis results in more advanced stage at clinical presentation and resultant poor outcome. CASE SUMMARY: We report here a case of testicular lymphoma associated with multiple cranial nerve palsies contributing to the diagnosis of an occult lymphoproliferative malignancy. CONCLUSIONS: In elderly men, accurate urologic examination is mandatory, particularly when other malignancies have been ruled out, since timely diagnosis of testicular malignancy may allow successful treatment. Paraneoplastic syndromes secondary to extranodal malignancies should be always taken into account in the evaluation of patients with multiple nerve palsies with no apparent primary neurologic disease.