Abstract
Abstract
Background
Although paediatric patients with acute lymphoblastic leukaemia (ALL) have improved survival following modern chemotherapy treatment, disease relapses still occur in 20–25% of them. Our case had relapsed ALL with testicular leukaemic infiltration, which is rare, with less than 2% incidence.
Case presentation
We describe a case of an 11-year-old boy with a background history of ALL presenting with painless unilateral scrotal swelling. An initial ultrasound of the testes showed heterogeneity throughout with hypervascularity on colour-flow imaging on the affected testis. Some areas are hypoechoic with dilated tubules. The histopathology of the follow-up testicular biopsy revealed malignant cells and leukaemic infiltration. Patient subsequently received chemotherapy treatment at another centre.
Conclusions
Testicular relapse of ALL is relatively rare with the use of improved contemporary frontline treatment with better outcomes. With its non-specific symptoms, radiological imaging can significantly facilitate timely diagnosis and contribute to appropriate further management and improved prognosis.
Publisher
Springer Science and Business Media LLC
Subject
Radiology, Nuclear Medicine and imaging
Reference10 articles.
1. Katz AJ, Chia VM, Schoonen WM, Kelsh MA (2015) Acute lymphoblastic leukemia: an assessment of international incidence, survival, and disease burden. Cancer Causes Control 26:1627–1642. https://doi.org/10.1007/s10552-015-0657-6
2. Nguyen K, Devidas M, Cheng SC, La M, Raetz EA, Carroll WL et al (2008) Factors influencing survival after relapse from acute lymphoblastic leukemia: a Children’s Oncology Group study. Leukemia 22(12):2142–2150. https://doi.org/10.1038/leu.2008.251
3. Pillai PM, Carroll WL (2021) Acute lymphoblastic leukemia. In: Fish JD, Lipton JM, Lanzkowsky P (eds) Lanzkowsky’s manual of pediatric hematology and oncology, 7th edn. Academic Press, pp 413–437
4. Nguyen HTK, Terao MA, Green DM, Pui CH, Inaba H (2021) Testicular involvement of acute lymphoblastic leukemia in children and adolescents: diagnosis, biology, and management. Cancer 127(17):3067–3081. https://doi.org/10.1002/cncr.33609
5. de Jesus LE, Dekermacher S, Resende GC, Justiniano RR (2022) Testicular involvement in pediatric acute lymphocytic leukemia: What to do about it? Int Braz J Urol 48(6):981–987. https://doi.org/10.1590/S1677-5538.IBJU.2022.0318