PT-LBCL had been treated principally with the CHOP regimen used in most cases of DLBCL, NOS. This regimen consists of three chemotherapy drugs (cyclophosphamide, hydroxydoxorubicin, and oncovin) plus a glucocorticoid (either prednisone or prednisolone); it achieved complete remission rates of >50%, 5 year median overall and progression-free survival times of 49 and 96 months, respectively, and cause-specific survival rates at 5 years of ~60%. However, rates of disease recurrence on this regimen were high with central nervous system relapses occurring after 5 and 10 years in 20% and 35% of cases, respectively, and contralateral testicular relapses occurring after 10–15 years in 5-35% of cases. More recently, the immunotherapy drug, rituximab has been added to the CHOP chemotherapy regiment to form the R-CHOP chemoimmunotherapy regimen. Rituximab is a monoclonal antibody that binds to the CD20 protein on, e.g. B-cells, and by doing so<unk> ts these cells for attack by the hosts adaptive immune system. The addition of rituximab improved the therapeutic efficacy of the CHOP regimen in almost all forms of DLBCL but has been somewhat less successful in PT-DLBCL<unk> ly because it does not cross the blood-brain barrier in appreciable amounts and therefore cannot treat or prevent central nervous system involvement. In consequence, current recommendations for PT-DLBCL include 1) the R-CHOP regimen; 2) systemic therapy with high dosage methotrexate, a drug which penetrates the blood-brain barrier or, in cases unable to tolerate high dose systemic methotrexate, intrathecal (i.e. injected directly into spinal fluid of the central nervous system) methotrexate; and 3) radiotherapy to the contralateral testis. For cases with central nervous system involvement at presentation, R-CHOP plus high dose intravenous and intrathecal methotrexate is recommended; for cases of<unk> tous meningitis R-CHOP plus cytarabine is recommended; and for cases in which patients have altered cardiac function and therefore unable to tolerate the cardiotoxic drug, hydroxydoxorubicin, R-CEOP (substitutes etoposide for hydroxydoxorubicin) is recommended.
Primary testicular diffuse large B-cell lymphoma
Testicular sarcoidosis
Transitional cell carcinoma of the ovary
Renal medullary fibroma
Renal anaplastic sarcoma
Metanephric adenoma
Multilocular cystic renal cell carcinoma
Renal cell carcinoma with t