Testicular infiltrate in childhood acute lymphocytic leukemia. The need for biopsy in suspected relapse.

The testicle is a prime initial target for infiltration during relapse in male children with acute lymphocytic leukemia. Herein wer report our experience with management of this entity in 8 childre. It is stressed that a biopsy is essential to the diagnosis. The differential diagnosis is usually straightforward. One is admonished not to make presumptive diagnosis by palpation. Orchiectomy is unwarranted. The treatment of choice is testicular radiation with 2,000 rads in ten fractions in a twelve-day course plus reinsstitution of high-dose adjunctive chemotherapy in those children off chemotherapy, or reinduction therapy for children who relapse while still on chemotherapy. Prognosis of male children who undergo a bout of testicular infiltration is guarded.