Testicular cancer, while relatively uncommon, remains a significant health concern, particularly among younger men. Early detection plays a substantial role in successful treatment outcomes. Ultrasound imaging serves as a primary tool for initial assessment and detection of testicular cancer. This non-invasive procedure provides detailed images that guide further diagnostic steps.
How Ultrasound Detects Testicular Cancer
Ultrasound uses high-frequency sound waves to create images of internal body structures. A handheld device, a transducer, emits sound waves that bounce off tissues and organs within the scrotum. The transducer captures the returning echoes, and a computer processes them into real-time images displayed on a monitor. Different tissues reflect sound waves differently, allowing radiologists to distinguish between various structures and identify abnormalities.
Radiologists examine characteristics of any detected mass, such as its size, shape, and internal texture, when assessing for testicular cancer. Solid masses within the testicle (intratesticular lesions) are more likely to be cancerous compared to fluid-filled cysts or lesions outside the testicle. Ultrasound also evaluates blood flow within the testicle using Doppler technology, as cancerous tumors often show increased vascularity. This detailed visualization helps differentiate between benign conditions and suspicious growths.
What to Expect During a Testicular Ultrasound
A testicular ultrasound is a straightforward, generally painless procedure requiring minimal preparation. You will typically lie on your back on an examination table, and the technician may position a towel to support the scrotum. A warm, water-based gel is applied to facilitate sound wave transmission and allow the transducer to glide smoothly. The technician then gently moves the transducer across the scrotum to capture images from various angles.
The procedure takes about 15 to 30 minutes, and you can resume normal activities immediately afterward. While generally comfortable, some mild pressure may be felt as the transducer is moved, and slight discomfort can occur if the area is already tender or swollen. This imaging method is safe and does not involve radiation exposure.
Interpreting Testicular Ultrasound Findings
Radiologists analyze ultrasound images to identify specific visual cues that might indicate testicular cancer. A solid mass located inside the testicle, often appearing darker (hypoechoic) than surrounding normal tissue, is a common finding that raises suspicion. These masses may also appear heterogeneous, with varied internal texture, sometimes with calcifications or cystic changes.
Distinguishing between intratesticular (within the testicle) and extratesticular (outside the testicle) lesions is important, as extratesticular masses are less often malignant. While ultrasound can suggest cancer by revealing a suspicious solid mass, it cannot definitively confirm a cancer diagnosis on its own. The images provide a detailed map of the abnormality, guiding further diagnostic evaluations.
Confirming a Testicular Cancer Diagnosis
If a testicular ultrasound identifies a suspicious solid mass, further steps are necessary to establish a definitive diagnosis. Blood tests check for specific tumor markers, such as alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH). Elevated levels of these proteins can indicate testicular cancer, though not all testicular cancers produce high levels of these markers.
Definitive diagnosis of testicular cancer requires a surgical procedure called a radical inguinal orchiectomy, which involves removing the entire affected testicle. This approach is favored over a biopsy to prevent potential cancer spread. The removed testicle is then examined by a pathologist to confirm the cancer, determine its type, and assess its characteristics. Once cancer is confirmed, additional imaging tests like CT scans may be performed to determine if the cancer has spread, known as staging.
When a Testicular Ultrasound is Recommended
A healthcare provider may recommend a testicular ultrasound if you experience certain symptoms affecting the testicles or scrotum. A palpable lump or swelling in either testicle is a common reason for this imaging. Other symptoms include pain or discomfort, a feeling of heaviness, or any noticeable changes in testicle size or shape.
Ultrasound helps investigate these symptoms and differentiate between conditions, such as fluid-filled cysts, inflammation, or a solid mass that could indicate cancer. Consulting a doctor promptly for any persistent or concerning scrotal symptoms is advisable. Early evaluation can lead to timely diagnosis and appropriate management.