Subject: Re: Lump, left testicle
Forum: The Urology Forum

Topic Area: Testicular Cancer

Hi, I'm 30 years old, I have a painless small lump in my left testicle, it has been there for 4 years, 2 years ago I went to an urologist because it was growing slowly, he performed a US, physical exam and infection study, the diagnostic at that opportunity was an infection due to Ureaplasma Urealyticum, so I took antibiotics for one month and the infection disappeared. In this 4 years the lump has been growing slowly, so I decided last month to go to another urologist, he performed a physical exam and US and said the lump is a epidydimal cyst of about 4mm. The questions are:
1.- I understand that internally the cyst is about 4 mm in size, but externally, when the scrotum is "fully retracted", I can see like a slowly growing bag of a size close to 15 mm in diameter at the top of the testicle, (this was the initial reason for the doctor's visit). Is this likely to be a consequence of the epidydimal cyst?
2.- Is there any possibility of misdiagnostic, in the sense that I could have testicular cancer from the begining, and I have lost these 4 years?
3.- I have been doing the self testicular exam like 3 times each day for a week and now it seems that the testicle is a little bit bigger and I feel little pain, could be this an inflammation due to the manipulation of the testicle?

Thanks for your response,
Joe

Dear Joe,
You have a three part question. First, in regards to the discrepancy between the 4mm epididymal cyst on ultrasound and the 15mm area felt on self examination, you may be feeling the entire epididymus. The wall of the epididymal cyst is usually 1-2 mm. Second, of course the ultrasound is not 100% accurate; however, it is thought to be excellent at determining if a lesion is in the testicle or outside the testicle. Lesions inside the testicle are likely to be cancerous whereas extratesticular lesions are not. The fact that the lesion has grown very little over a 4 year time period makes the diagnosis of testicular cancer highly unlikely. Finally, it is possible that manipulating scrotal contents several times a day may cause swelling and bruising. Testicular self examination is recommended once a month.
This information is provided for general medical information purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available through our department at the Henry Ford Hospital and its suburban locations (I-800-653-6568).

Sincerely HFHS M.D.-CK
*Keyword: testicular cancer

Follow Ups:

• Lump, left testicle Joe 5/11/1999 (1)
  • Re: Lump, left testicle HFHS M.D.-AK 5/12/1999 (0)

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