Cyst or Tumor?

About 3 years ago I went to have a checkup with a Urologist and he found a small knob at the top of my testicle that was the size of a "BB".  It was stationary and "attached" to the top of my left testicle very close to or immediately at the site of the epidydimus. But on the testicle.  Without a second thought, he declared it was nothing more than a typical testicular cystis, or cyst.  I asked him if he was sure, and he said yes.  I forgot why he was so sure by simply feeling it.

My questions:

1)  Is there something unique about a cyst that makes it possible to diagnose it as a cyst VERSUS a tumor using only your fingertips, and feeling it? I thought an ultrasound was the only way to tell?

2)  Last month I had some chest pain, fever that spiked to 102.6 then stayed at 100 for about 3 weeks along with a dry cough for a total of 4 weeks.  Cough only stopped with a steroid inhaler to deal with irritation/inflammation which Im still on.  All X-rays were completely normal.  Is it accurate to state that if I did have testicular cancer and it had spread to my lungs/chest in the last 3 years, they would have seen it on the XRays?

3)  Around the time this knob was discovered, my ejaculate volume had literally decreased in half.  Might be coincidental, might not.  If this is a cyst, and it is blocking my ejaculatory tubes a little, or completely, is there a safe, side effect free way to surgically remove it, and restore ejaculation flow?

4) I rediscovered the cyst tonight, having forgotten totally about it.  Its still there and it is still the same exact size.  Given all the information above, do I have reason to be concerned, or should I be content with the diagnosis of 3 years ago?

Thanks.

[Kevin Pho, MD]

To answer your questions:
1) There are some physical exam characteristics that can differentiate a cyst from a tumor, but an ultrasound would be the best step.

2) If there are evidence of a lung tumor, it may be seen during x-rays.  A chest CT scan would be the optimal test if this is suspected.

3) The surgical therapies to remove a cyst is normally effective and safe.  However, the outcome may be affected by the size and location of the mass.

4) Difficult to say without examination.  I would consider an ultrasound to cement the diagnosis.

These options can be discussed with your personal physician.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Kevin, M.D.
http://www.straightfromthedoc.com

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