Hypoechoic solid nodule on left testicle

4 weeks ago started some pulling sensation on my left testicle. Then 3 weeks ago, had ejaculation and left testicle was in slight pain. Slight fever. Went to hospital and did ultrasound and found hypoechoic solid nodule on left testicle (0.2x0.3x0.4cm). Saw urologist yesterday. Told me there's no biopsy involved when comes to checking for testicular cancer. Too risky. Asked me to go for 2nd ultrasound in 2 months time.

Questions:
1. Is it there's no testicular biopsy to check for testicle cancer?
2. 2 months to go for 2nd ultrasound? What if it spread?

[S. Kaul, MD]

Hi there!

1. Yes a testicular biopsy is never recommended and the testicle is removed at suspicion of a malignancy and biopsy done after orchidectomy.
2. Well, management is largely dependent on the risk and level of suspicion; though seminoma is not typically one of the most aggressive tumours. 0.2x0.3x0.4cm is a small size and not expected to spread in 2 months even if it happens to be a seminoma. One could also consider running PLAP and hCG levels.
Hope this helps.

Take care!