Discovering a lump or changes in the testicles can cause anxiety, leading to concerns about testicular cancer. While serious, many other conditions present with similar symptoms. These are frequently benign and treatable. This article details common non-cancerous conditions that may mimic testicular cancer.
Conditions Involving Fluid Accumulation or Cysts
Fluid accumulation around the testicle, a hydrocele, can cause scrotal swelling mistaken for a solid mass. Fluid collects in the sac surrounding the testicle. Hydroceles can be congenital or develop later due to injury, infection, or inflammation. Symptoms include painless swelling.
Diagnosis usually involves a physical examination, where a doctor might shine a light through the scrotum to observe transillumination, indicating fluid. An ultrasound often provides further confirmation, ruling out other causes of swelling. Treatment is generally not required unless large, uncomfortable, or affecting blood supply, requiring surgical drainage or repair.
A spermatocele, or epididymal cyst, is a fluid-filled sac that develops in the epididymis. The epididymis is a coiled tube at the back of the testicle storing and carrying sperm. Spermatoceles typically contain milky or clear fluid, sometimes including sperm.
These benign cysts usually do not cause pain or require treatment unless large enough to cause discomfort. They present as a smooth, distinct lump, located above or behind the testicle, feeling separate from the testicle. An ultrasound confirms diagnosis by distinguishing the fluid-filled cyst from a solid mass.
Inflammatory or Infectious Conditions
Epididymitis, inflammation of the epididymis, is a common cause of scrotal pain and swelling. It often results from bacterial infection, including sexually transmitted infections (STIs) or urinary tract infections (UTIs). Urine reflux, where urine flows backward into the epididymis, can also trigger it.
Symptoms include gradual onset of pain, tenderness, and swelling in the affected testicle. Fever, chills, and penile discharge may also be present. Diagnosis involves physical examination, urinalysis, and ultrasound.
Orchitis is inflammation of the testicle, occurring with or without epididymitis. Viral infections, particularly mumps in unvaccinated individuals, are a common cause, though bacterial infections can also be responsible. It can lead to significant pain, swelling, and tenderness in one or both testicles.
Patients may experience fever, nausea, and general malaise. A doctor will conduct a physical examination and may order urine, blood tests, or an ultrasound. Treatment depends on the underlying cause; bacterial infections are managed with antibiotics, while viral orchitis requires supportive care.
Structural and Vascular Abnormalities
Varicoceles are enlarged veins within the scrotum, similar to varicose veins in the legs. These dilated veins, often described as feeling like a “bag of worms,” result from faulty valves in the spermatic cord veins. They are more commonly found on the left side of the scrotum.
While many are asymptomatic, some individuals may experience a dull ache. In some cases, they can affect fertility. Diagnosis typically involves a physical examination (especially when standing) and an ultrasound to visualize enlarged veins and assess blood flow.
An inguinal hernia occurs when intestine or abdominal fat pushes through a weak spot in the abdominal wall, protruding into the groin or scrotum. This creates a bulge that might be mistaken for a testicular mass. Common causes include straining, heavy lifting, or congenital factors.
The bulge may become more prominent with coughing, straining, or standing, often receding when lying down. Pain or discomfort in the groin or scrotum, especially during activity, is common. A physical examination can diagnose an inguinal hernia; the doctor can feel the bulge and may ask the patient to cough.
Testicular torsion is a medical emergency where the spermatic cord, supplying blood to the testicle, twists. This cuts off blood supply, leading to rapid tissue damage if not addressed quickly. It can occur spontaneously and is more common in adolescents but can affect males of any age.
Symptoms are typically sudden and severe, including intense scrotal pain, swelling, abdominal pain, nausea, and vomiting. The affected testicle may appear higher than normal. Immediate medical attention is critical, usually within six hours.
When to Seek Professional Medical Advice
Any new lump, swelling, pain, or changes in the testicles warrant immediate medical evaluation. While many scrotal conditions are benign, only a doctor can accurately diagnose the cause. Self-diagnosis is not sufficient, as serious conditions like testicular cancer can present with similar signs to less concerning issues.
A thorough medical evaluation involves a physical examination of the scrotum and abdomen. Diagnostic imaging, such as an ultrasound, differentiates between solid masses, fluid collections, and other abnormalities. Blood tests may also check for infection or tumor markers.
Prompt diagnosis is important for any testicular condition. Early detection allows for timely treatment and symptom management, preventing complications. For testicular cancer, early detection significantly improves outcomes and prognosis.