Lump on testicle.

Hello sir. i am a 24 yr old male from greece. I am on methotrexate from the age of 22 because of seronegative arthritis and my dose is 5mg per week.



2 weeks ago i found a hard small lump on my right testicle about 2mm size , on the top of it,near the epidydimitis but not on it(the lump  is ON the testicle not just floating in the scrotum).Knowing about testicular cancer, i went to a urologist who felt it and suggested that i should have a scrotum ultrasound. so i went the next day and took the exam, which was clear, for both testicles. Although the radiologist felt it with his fingers he told me that there was nothing on the screen and suggested that either i should have an MRI test just in case or just leave it, so the ultrasound was clear. Then i went to a second urologist who felt it again and said it was a morgagni cyst.

I came home and read about morgagni cyst but i found out that my lump is not moveable like the internet sites suggested, so i informed my original urologist about the ultrasound and the morgagni diagnosis. He said that it is possible that this is a morgagni cyst after torsion, and suggested that i should leave it as it is and check if there is any change in the future.I must add that i self-examined my OTHER testicle (left one) and i found out that there is a lump in the same spot (top of testicle, near the epidydimitis) but it is bigger, much softer and moveable, like the description of a normal morgagni hydatid. I must also add that i have varicocele in my left AND right testicle from the age of 18.



So my questions are :

1)Since i never had a swollen scrotum that would suggest an morgagni cyst torsion, and i occasionally feel pain because of my varicoceles, is it possible that my right testicle lump is indeed a morgagni cyst (after torsion) that i didnt notice?



2) What can i do in order to find out what that lump is? I cant just wait thinking i might have testicular cancer and feeling doomed like a dying man. The lump is very small (2mm) right now so i have to wait and see if it is going to be bigger in order to have a second scrotum ultrasound and i just cant get it off my head. Thank you.

[Vanessa Lacuesta]

Hi.

In your case, the physical examination may offer  a string of differentials or conditions which may likely explain the lump. The ultrasound did not show anything significant and this should offer some relief. Monitoring the lump may be the step to undertake. Note for any changes and character of the lump. Watch out for pain, swelling and discoloration in the area. Note for any asymmetry in the scrotal sac. You may ask your physician when a follow up ultrasound scan may be done to assess the lump.

At this point, an MRI scan may be done to help ascertain the likelihood that this is a cyst and not a solid mass. It will also help identify involvement of nearby structures. However, your ultrasound scan was unremarkable. At this point, an MRI scan is not really necessary.