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Case report
Isolated testicular recurrence of B cell acute lymphoblastic leukaemia in an adult: rare case
  1. Thejus Jayakrishnan1,
  2. Hira Shaikh1,
  3. Yazan Samhouri2,
  4. Ariel Sandhu3 and
  5. Salman Fazal2
  1. 1Internal Medicine, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
  2. 2Medical Oncology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
  3. 3Pathology, Allegheny Health Network, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Thejus Jayakrishnan; thejus.jayakrishnan{at}


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.

  • malignant disease and immunosuppression
  • immunology
  • malignant and benign haematology
  • chemotherapy
  • urological surgery
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  • Contributors Each author meets all the following four criteria: conception and design, acquisition of data or analysis and interpretation of data. Drafting the article or revising it critically for important intellectual content. Final approval of the version published. Agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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