Isolated testicular recurrence of B cell acute lymphoblastic leukaemia in an adult: rare case.
Thejus T JayakrishnanHira ShaikhYazan SamhouriAriel SandhuSalman FazalPublished in: BMJ case reports (2019)
An 80-year-old man who was previously diagnosed with Philadelphia+ B cell-acute lymphoblastic leukaemia (B-ALL) in remission post-allogeneic matched unrelated donor peripheral blood stem cell transplant. Five years later, he was found to have unilateral testicular relapse of Philadelphia+ B-ALL proven by pathology after radical orchiectomy. Bone marrow aspirate and biopsy did not show evidence of leukaemia. Patient was treated with adjuvant radiation therapy and started on dasatinib 50 mg daily. Given his age and absence of disseminated acutelymphoblastic leukaemia (ALL), no adjuvant chemotherapy was utilised. He is monitored with monthly PCR studies. At 1-year follow-up, no findings suggestive of recurrence of ALL have been identified and the patient is maintained on the dasatinib. Although isolated testicular recurrence is common among paediatric population, it is a rare event among adults as it is considered an immunological sanctuary for cancer cells.
Keyphrases
- bone marrow
- free survival
- rare case
- chronic myeloid leukemia
- liver failure
- acute lymphoblastic leukemia
- peripheral blood
- stem cells
- radiation therapy
- germ cell
- respiratory failure
- case report
- stem cell transplantation
- drug induced
- emergency department
- aortic dissection
- physical activity
- intensive care unit
- mesenchymal stem cells
- squamous cell carcinoma
- ultrasound guided
- rheumatoid arthritis
- hepatitis b virus
- disease activity
- systemic lupus erythematosus
- extracorporeal membrane oxygenation
- fine needle aspiration