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Urology (Expert Forum)
Scared about lumps/cysts, possible hypochondria?
Questions in the Urology forum are answered by Dr. Stephen Liroff, affiliated with the Henry Ford Hospital. Topics covered include benign prostate disease, penis curvature, cystisis, kidney stones, pediatric urology, prostate, sexual dysfunction, urinary tract infections (UTI), and urological cancers.
Scared about lumps/cysts, possible hypochondria?
by Joe__0__0, Apr 08, 1999 12:00AM
Doctor,
Please set this 25-year-old straight. I was diagnosed about a month ago with
what my urologist has called a "cystic mass on the lower pole of
the left testicle, probably the beginning of a spermatocele." I
initially felt a painless lump, more or less a raised ridge, on one
of the poles (my inexperienced hands don't know up from down) of
my left testicle and went to see the urologist who did the
ultrasound and came up with this diagnosis. He felt no blood
marker tests were necessary.
At the time, I failed to tell him about the back pain near my
tailbone on the left side because it wasn't until I started
surfing the 'Net that I realized back pain is a symptom of
testicular cancer. The back pain is not severe nor steady and I
notice it when I have been standing for a while or as a "soreness"
when I initially rise from bed in the morning. In addition, in my
paranoia, I have been examining myself since my urologist visit
and have found a smaller lump on my right testicle in a polar
location, although this one feels less like a ridge and a bit more
defined.
I hesitate to call the urologist about this matter because I fear
I will be perceived as a hypochondriac (which may in fact be the
case) and because I made a couple of follow-up calls to him after
my visit, but before the back pain/right side findings. In
addition, as a full-time graduate student, my health insurance
situation is not great and this could get costly. But on the
other hand, I still fear a problem. Any suggestions?
Thank you.
Doctor's Answer
by hfhs M.D.-AK, Apr 08, 1999 12:00AM
_
Dear Joe,
Ultrasound is the principle diagnostic tool for evaluating the testes. It is well suited for this purpose because it is noninvasive, does not cause patient discomfort, and uses no radiation. The ultrasound can differentiate between intratesticular masses and extratesticular masses as in your case. The accuracy of testicular ultrasound has been reported at greater than 90% with lesions as small as 4 mm.
If the ultrasound is negative for cancer, the chances of your back pain resulting from testicular cancer is nearly zero. Back pain is only a finding in patients with advanced disease with metastasis. If your doctor has told you that you have a cyst, I think you can trust that he is correct. For the other lump you felt, I think you should continue with your self examinations and bring it to the attention of your doctor if any change occurs.
I think you can feel secure with your doctors diagnosis and follow-up as directed.
This information is provided for general medical educational purposes only. Please consult your physician for diagnostic and treatment options pertaining to your specific medical condition. More individualized care is available at the Henry Ford Hospital and its satellites (1 800 653-6568).
Sincerely,
HFHS M.D.-AK
*keyword:Testicular Cancer
