Cyst or Cancer

  I have a conern (a big one). I have a lump on the end of my left testicle, (though it is like a small marble say 8mm). This 'little ball' is only connected by a small section of itself. Its a bit like a small space ship docking with a bigger one. It is quite hard, though not painful. I am travelling/working in Eastern Europe, and I went to a Uroligist in Vilnius (Lituania) who said after a physical check that it was a cyst "not a problem !". I asked for a US, and he said his fingers were as good as a US. I have read all the stuff on the internet - and it seems to indicate any lump on the testes is 95% cancer - so I went to see a local Oncologist (?), cancer doc, he said it was a cyst to. So what is my next step. By the way what is intetestical what is extratestical ? Thankyou (sorry about the length)

[hfhs M.D.-AK]

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Dear Barber,
This you call a little ball is probably consistent with what is known as a spermatocele or epididymal cyst.  Your doctor, Urologist, is trained well enough to tell you on a physical examine if this is a cyst.  What he means by intratesticular is a mass growing out of or inside the testicle itself.  What you have described to me is an extratesticular mass that is non tender and separate from the testicle.  Most extratesticular masses are benign and do not need to be removed unless they cause you pain or discomfort.
A spermatocele is a cystic structure or outpouching of the epididymus.  The cyst itself is usually firm and nontender as is yours.  It is usually filled with sperm and epididymal fluid.  It is possible for it to lead to a decrease in fertility however this is uncommon.
If you are still concerned and you just can