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Testicular relapse in Acute Lymphoblastic Leukemia (ALL): A simple problem of common sense

Antonio Gentil Martins*

The testis are the second most frequent site for extra medullary recurrence in ALL. Local therapy is not uniform in different study groups. In the classical Protocol POG 8034, as well as in ALL-REZ, COG, BFM 2002, UK ALL-R3 or the COPRALL (1,2,3, there is no clear specific reference to unilateral or bilateral testicular recurrence). But it appears that everyone accepts that recurrence in the testicular sanctuary will always, at least potentially, be bilateral (even if it may be only more evident on one side) and then requires local irradiation or complementary orchiectomy.