RESUMO
A 33 year-old male, who five years earlier was operated for a nodular melanoma in vertical growth phase of 1.5mm thick (Breslow), Clark II-III, presented to the Emergency department with a progressive increase of the left testicle. Ultrasound scan examination revealed a 2 x 2 cm solid mass in the left testis, with normal right testis.With the diagnosis of testicular neoplasm, we requested Alpha-fetoprotein and beta HCG levels, and patient underwent radical orchiectomy.
Assuntos
Melanoma/secundário , Neoplasias Testiculares/secundário , Adulto , Evolução Fatal , Humanos , Masculino , Melanoma/patologia , Neoplasias Testiculares/patologiaRESUMO
OBJECTIVE: To describe the clinical and radiological features, and the role of imaging in diagnosis and extension study of testicular lymphoma (TL). METHODS: Testicular and inguinal color Doppler ultrasound, extension-study Multidetector Computed Tomography (MDCT), and Doppler ultrasound and MDCT in an upper extermity metastasis were performed. RESULTS: Case 1: A 65-year-old man with TL 11 years ago, recurrence in the contralateral testis 5 years later, orbital involvement at 8 years and currently recurrence in the arm with ulnar nerve infiltration. Case 2: A 44-year-old man with TL and metastatic inguinal lymphadenopathy. Case 3: An 85 year-old man with TL, retroperitoneal lymph nodes and obstructive uropathy. Histological subtype: B-cell non-Hodgkin's lymphoma. CONCLUSIONS: TL typically presents as an aggressive disease with contralateral testicular involvement and spreading to regional lymph nodes and non-contiguous extranodal sites. The main radiological techniques are Doppler ultrasound for the study of the primary disease and MDCT in the evaluation of disease extension. Diagnosis is usually obtained after orchiectomy by histological study, and despite the aggressive treatment modalities (surgery associated with radiotherapy or chemotherapy) prognosis remains poor.
