Re: hard lump on testicle

Subject: Re: hard lump on testicle

Forum: The Urology Forum


I want to first thank everyone for providing this service.
I am 25 and had an undescended right teste repaired as infant.  Two months ago, I found a painless hard lump a little larger than a BB at top of left teste. It is definately connected and located about an eighth of an inch to the left( from doctors view) of the joining of epiditymis. I had an ultrasound that didn't find the lump. My urologist said it was the appendix testes and not to worry, but I never felt it before and lit I have read said that condition is very painful. Since I have no pain and a little labored breathing(though it could be congestion) I only want to know if this still sounds like a likely prognosis. I realize you can't say for sure, but this is driving me crazy and I only want to know if anything I have said leads you to believe it is not the appendix testes. I don't want to relax simply because it's an UNLIKELY location for cancer. Also are there any web sites that would provide me with info on this condition?





Dear Bob,
Scrotal masses secondary to testicular causes consist of a tumor within the testicle or a testicular appendage.   Some patients are born with remnants of tissue on the testicle called an appendix testis.  A testicular appendage can intermittently twist on its blood supply and cause pain.  Classically this is seen as a blue dot on the scrotum.  Testicular appendages are not inside the testicle. To determine if the mass is inside the testicle, a physical exam and an ultrasound of the scrotum may be performed.  
A patient with a solid, firm, intra-testicular mass is testicular cancer until proven otherwise.  The cancer is usually painless.  It most commonly affects 20-40 year old men.  Whites are affected 3 X more than blacks.  Risk factors include prior testicular tumor and cryptorchidism (undescended testis).  It does not sound like you have testicular cancer, but you are in the age group. Because of your history of an undescended testicle, you are at an increased risk of testicular cancer.  This risk applies to both testes.  An ultrasound is a good screening test for testicular cancer.  Another test would be to draw serum markers for testicular cancer (LH, B-HCG, AFP).  You should also have a chest x-ray to evaluate your difficulty breathing.   If all of these are normal, then an appendix testis may be the diagnosis of exclusion.  In the meantime, you should perform monthly self testicular exams.  If you are concerned, contact your Urologist.
More individualized care is available at the Henry Ford Hospital and its urban campuses by calling  (1 800 653 6568). We can also arrange local accommodations through this number if this is your need. Please bring any physicians' notes and lab test results that you  may be able to obtain. These will help us greatly.
HFHS M.D.-JL
*Keyword:testicular cancer, appendix testes








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