Testicular Relapse in Acute Lymphoblastic Leukemia (ALL): Guidelines Must be Changed

Guidelines for the treatment of testicular recurrences need to be changed: a patient with unilateral testicular recurrence of ALL has been unnecessarily castrated by irradiation. The patient has been free of disease for 12 years, having had chemotherapy, several bone marrow transplants and left Orchyepididimectomy. Nevertheless, due to irradiation of the right testicle, he has been left permanently under hormonal replacement and with unavoidable infertility. This outcome could have been avoided if treatment guidelines had been changed and a different approach was taken. This confirms some more recent studies, although with the drawback of the number of affected patients being small.