Extranodal diffuse large B-cell lymphoma of the spermatic cord: The first reported case in Saudi Arabia

Primary spermatic cord lymphoma is rare, accounting for 1.6 % of spermatic cord tumors. It typically presents as diffuse large B-cell lymphoma (DLBCL) with aggressive course and poor prognosis. A 53-year-old male presented with progressive left testicular mass over one year. Imaging revealed spermatic cord tumor. Radical orchiectomy and histopathology confirmed stage IV Extranodal DLBCL. Patient received 6 cycles CHOP-R chemotherapy plus 2 additional Rituximab cycles, achieving favorable response despite advanced disease. This case emphasizes importance of early diagnosis, advanced imaging, and multidisciplinary treatment for this rare aggressive malignancy.