Chapter 18 – Male Sexual Dysfunction, Prostate Disease and Testicular Lumps

Testicular lumps

Differential diagnoses of testicular lumps include:

testicular cancer benign lumps epididymal cysts spermatocele hydatid of Morgagni hydrocele

Examination of the testes and local lymph nodes is important. It may be difficult to distinguish between testicular and epididymal cysts. Lumps in the epididymis are rarely cancer. Lumps in the testes are nearly always cancer. When a patient presents with a testicular or scrotal lump, it needs to be investigated by scrotal ultrasound.

Testicular cancer is a condition where abnormal cells develop in the testicle. These cells then grow, divide and multiply, creating a growth or tumour. It will usually appear as a painless lump on the testicle. Many lumps are found to be fluid-filled cysts (growths), rather than cancer. Testicular cancer has a cure rate of over 95 per cent, and is uncommon.(19)

If the patient is between 20 and 40, they’re in the age group with the highest risk of developing testicular cancer. Testicular cancer is the second most common cancer among men aged 20 – 40.(19)

There is insufficient evidence to recommend routine screening for testicular cancer, however, opportunistic examination can be considered in those at higher risk (e.g. those with a history of cryptorchidism (undescended testes), orchidopexy, testicular atrophy, or previous testicular cancer).Buy now