Discovering a lump on a testicle can be an unsettling experience. While many testicular lumps are not cancerous, any new or unusual lump requires prompt medical evaluation. Seeking professional medical advice ensures an accurate diagnosis and appropriate management.
Common Causes of Testicular Lumps
Many testicular lumps are benign. One frequent cause is an epididymal cyst, a fluid-filled sac that develops in the epididymis, the coiled tube behind the testicle that stores and transports sperm. These cysts are typically painless, smooth, and firm, feeling like a pea-sized lump on top of the testicle. They often do not interfere with fertility and may not require treatment unless they cause discomfort or grow significantly.
Another common benign cause is a hydrocele, which involves a buildup of watery fluid around one or both testicles, leading to scrotal swelling. Hydroceles are often painless, though a large one can create a feeling of heaviness or discomfort. While common in newborns and often resolving on their own, they can occur in adults due to injury, inflammation, or infection.
Varicoceles are also a frequent cause of testicular lumps, characterized by enlarged veins within the scrotum, similar to varicose veins found in legs. These swollen veins, often described as feeling like a “bag of worms,” typically develop gradually above the testicle, most commonly on the left side. Varicoceles may cause a dull, aching pain that can worsen with prolonged standing and improve when lying down, and they are a common cause of male infertility.
Inflammation or infection can also lead to a testicular lump, such as epididymitis, an inflammation of the epididymis. This condition often results from a bacterial infection, including sexually transmitted infections, and can cause pain, swelling, redness, and warmth in the scrotum. The pain can range from mild to severe and may spread to the groin.
Testicular Cancer
While many testicular lumps are benign, testicular cancer is a serious condition that requires prompt attention. It involves the development of cancer cells within the tissues of one or both testicles. It is a relatively rare cancer but is the most common cancer in males aged 15 to 40, though it can occur at any age.
The most common presentation of testicular cancer is a painless lump or swelling in the testicle. This lump may feel firm and can be accompanied by a change in the size or shape of the testicle. Although pain is not typical, some individuals might experience a dull ache or a feeling of heaviness in the scrotum. A lump directly within the body of the testicle itself has a high probability (around 90%) of being cancerous.
Risk factors for testicular cancer include a history of undescended testicles (cryptorchidism), a family history of the disease, and certain genetic conditions. However, many men who develop testicular cancer do not have any known risk factors, underscoring the importance of self-examination and awareness. Early detection is important for successful treatment outcomes, as testicular cancer is highly curable when caught in its early stages. Regularly checking for any changes in the testicles allows for timely medical evaluation if a suspicious lump is found.
When to Seek Medical Attention
Any new lump or swelling found on a testicle should always be evaluated by a healthcare professional without delay. While many testicular lumps are not serious, it is impossible to determine the cause without a medical examination. Professional medical advice is important, as self-diagnosis is not sufficient and can lead to missed diagnoses of serious conditions.
Certain symptoms warrant immediate medical attention. These include sudden, severe pain in a testicle, especially if accompanied by nausea, vomiting, or abdominal pain, which could indicate testicular torsion—a medical emergency where the testicle twists, cutting off its blood supply. Rapid growth of a lump, significant pain, redness, or fever also require urgent medical evaluation. Any noticeable change in the size, shape, or feel of a testicle, or persistent aching or discomfort, should prompt a visit to a doctor.
Diagnosis and Management
Upon discovering a testicular lump, a healthcare provider will typically begin with a physical examination of the scrotum and testicles. During this examination, the doctor will assess the lump’s size, consistency, and location, and may shine a light through the scrotum to check for fluid accumulation, a technique known as transillumination. Fluid-filled structures like hydroceles and epididymal cysts will allow light to pass through, while solid masses will not.
Further diagnostic tools often include an ultrasound scan of the scrotum, which uses sound waves to create detailed images of the testicles and surrounding structures. This imaging technique can help differentiate between fluid-filled cysts, enlarged veins, and solid masses, providing important information about the lump’s nature. In cases where testicular cancer is suspected, blood tests may be ordered to check for specific tumor markers, which are substances that can be elevated in the presence of certain cancers. These markers can include alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH).
Management of a testicular lump varies significantly depending on the underlying cause. Benign conditions like small epididymal cysts or hydroceles that do not cause symptoms may simply be observed over time, as they often do not require intervention. Infections such as epididymitis are typically treated with a course of antibiotics to resolve the inflammation. If a hydrocele or varicocele causes persistent discomfort, significant swelling, or affects fertility, surgical correction may be considered. For testicular cancer, treatment usually involves surgical removal of the affected testicle, often followed by additional therapies such as chemotherapy or radiation, depending on the stage and type of cancer.