A man in his late 20s presented with a 7 day history of painless right scrotal swelling. Scrotal ultrasound revealed complete tumour infiltration of the right testis and two-thirds infiltration of the left testis. A right radical orchidectomy and left testicular biopsy confirmed B-lymphoblastic leukaemia/lymphoma. Subsequent bone marrow and peripheral blood tests showed no systemic involvement. Persistent left testicular disease was found following induction chemotherapy, and orchidectomy of the contralateral testis was subsequently conducted. This case highlights the unique nature of bilateral testicular involvement of B-lymphoblastic lymphoma in an adult and provides further data on the management of this rare disease.
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