Relapsed testicular lymphoma presenting with cranial nerve neurolymphomatosis.

Rapidly progressive hearing loss and dizziness developed in an 82-year-old man with testicular diffuse large B-cell lymphoma, treated 3 years previously. Examination revealed bilateral hearing loss, mild right facial palsy, and wide-base gait. Brain MRI revealed thickening of the right V and bilateral VII and VIII nerves (figure), without brain or meningeal involvement. The CSF showed no malignant cells. The absence of brain parenchymal disease suggested cranial nerve neurolymphomatosis, infiltration by neurotropic neoplastic cells, a rare manifestation of hematologic malignancy.1 Testicular lymphoma may involve the CNS, but rarely with cranial nerve neurolymphomatosis.2