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Urology (Expert Forum)
Testicular mass
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.
Testicular mass
by Gary__0, Mar 06, 1999 12:00AM
I am a 31 year old male who is sexually active. On my left testicle I have a bump that appears and seems to go away from time to time. The testicle is sometimes sore; however, I suspect this is due more in part to my constant checking than anything else. When I was 15 I had a hernia operation to remove a water mass from that testicle and the result left the left larger and shaped differently from the right. This makes comparison somewhat useless. My doctors appear more concerned first come first serve and have scheduled me 2.5 weeks out. And based off of my previous visits for other ailments (twisted knee, dislocated shoulder, etc) I am not looking forward to any real answers from them. Should I go to the emergency room or wait? Does the fact that the bump (size of an M&M) go away rule out cancer. Any answer would be appreciated. Thanks, Garry.
Doctor's Answer
by HFHS MD JL, Mar 06, 1999 12:00AM
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Dear Gary,
Scrotal masses secondary to testicular causes consist of infection (epididymo-orchitis), fluid around the testicle (hydrocele), blood around the testicle (hematocele) or a tumor within the testicle. Some patients are born with remnants of tissue on the testis called testicular appendages. A testicular appendage can twist on its blood supply and cause pain. Classically this is seen as a blue dot on the scrotum. Its possible that it may feel like an M&M. This process of twisting can be intermittent. 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 should 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. A testicular cancer does not come and go. Given your history of surgery on the left groin, what you may have is a recurrent hydrocele in the testis. 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: scrotal mass, testicular cancer, hydrocele
