testicular swelling; testicular mass
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Etiology
- hydrocele
- epididymitis, orchitis
- varicocele
- inguinal hernia
- testicular cancer
- primary testicular lymphoma (most common in men > 60 years)
- germ-cell tumors (seminoma)
- rhabdomyosarcoma
- stromal tumors
- genitourinary sarcoidosis
- pharmaceuticals (bilateral, may be better labeled macroorchidism)
Clinical manifestations
- hydocele & testicular cancer may be painless
- epididymitis & orchitis likey associated with some pain
Laboratory
prior to histologic diagnosis (levels fall after orchiectomy)
* alpha-fetoprotein in serum is never elevated in pure seminomas
* beta-chorionic gonadotropin in serum is elevated in ~20% of pure seminomas[2]
Diagnostic procedures
- testicular ultrasonography
- heterogenous, hypoechoic testicular mass most likely testicular cancer
Management
- depends upon etiology
- trial of antibiotics for suspected infectious etiology
- orchiectomy may be necessary for tissue diagnosis
More general terms
Additional terms
References
- ↑ Thompson RW, Yu H, Dahl DM et al Case 10-2018: An 84-Year-Old Man with Painless Unilateral Testicular Swelling. N Engl J Med 2018; 378:1233-1240 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/29590543 <Internet> http://www.nejm.org/doi/full/10.1056/NEJMcpc1712224
- ↑ 2.0 2.1 2.2 Medical Knowledge Self Assessment Program (MKSAP) 18, American College of Physicians, Philadelphia 2018