The ultrasound showed 3 cysts outside the testicle ( the biggest is 0.8 mm) and also a bluish lump . The urologist said the testicle is normal and the bluish lump may be a torsion of something tiny up in the scrotum and that this should disappear in about two weeks, but no the cysts, these should left there if there is not discomfort.
Test # 3 and #4 came back normal.
Test #2 : HCG value is 12. I know this should be less than 5 for men. The Urologist asked us to repeat this test and if it results high again we should go to the endocrinologist because he saw the ultrasound normal.
My question are:
1- Can a HCG value of 12 still be considered normal for a 14 year old boy?
2- How high should HCG value be to suspect testicular or some other type of cancer?
3- I am very uncomfortable with the result and would like more assurance that this indeed is not a concern for cancer. Do you recommend some other study or test?
Usually the "blue dot sign" is associated with significant pain and in some cases, swelling. It represents a twist of a small, non-functional structure that hangs off the testis or epididymis. The ultrasound would not demonstrate the color of this. If it was a doppler ultrasound, the color represents blood flow. A follow-up Beta HCG and a repeat scrotal ultrasound at this time would be a reasonable and non-invasive further evaluation. The cysts that are outside the testis are usually not something that needs treatment unless they are changing (enlarging, developing solid components.)
The direct answer to your question about the HCG value is that if you are referring to a BETA -HCG, then 5 is the upper limit. If the value is not in the normal range on repeat, then further evaluation needs to be pursued.
S.A. Liroff, M.D.
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