A large left testical since I was a little boy...

[Brian__0__0]

  Ever since I was about 12 or 13, I've noticed that my left
  testical was much larger than my right one. Also, it had lumps
  all over it. Not small ones, not just on the top or bottom,
  but all over it. I'm not 19, and I just TONIGHT got up the nerve
  to tell my father about it. Tomorrow I'm going to the doctor
  to have it checked out. For years it didn't hurt, but today it
  felt as though someone kicked me there, and I was just sitting
  in a chair. What could this possibly be? Cancer? A cist? is
  there a possibility that it's nothing?
  Thank you,
  Brian

[hfhs M.D.-AK]

_
Dear Brian,
You did the right thing about telling your parents.  You certainly do need to see a doctor.  From your description, its sounds very suspicious for some type of abnormal growth or structure. There are several structures and potential abnormalities that can account for the description you gave however the most important reason to be evaluated is to rule out cancer..  These  other structures are  a spermatocele, hydrorocele, varicocele, or hernia.  All of these can be better characterized on physical exam.  If there is any question, an ultrasound can be obtained to determine if the mass is intratesticular or extratesticular.  There is a big difference if the mass is coming or growing inside the testicle or from the surrounding structures.
A spermatocele is a cystic structure or outpouching of the epididymus.  The cyst itself is usually firm and nontender.  It is usually filled with sperm and epididymal fluid and considered a benign lesion.  It is possible for it to lead to a decrease in fertility however this is uncommon.  The most important  part of diagnosis is to make sure there is no cancerous lesion.  Again this can be evaluated by a good physical exam or ultrasound.
A hydrocele, is simply fluid around the testicle, but this would not account for the lumps you feel.
Next is a varicocele which is similar to varicose veins.  These are enlarged vein around the testicles and in the scrotum.  About 15% of normal males have this condition.
And lastly, a hernia which is a hole in the abdomen allowing the bowel to escape from the abdomen.  Sometimes the bowel can extend down into the scrotum.
I certainly can’t tell you if this is a cancerous lesion over the internet.  Without examining you, I don’t want to comment other than instructing you to see the urologist.  If you have a lump in your scrotum you need to be examined by a physician and bring it to his attention.  An ultrasound should be performed if the testicle cannot be fully examined or if there is any question about this diagnosis.
This information is provided for general medical educational purposes only.  Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition.  More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Testicle lump