Scrotal Mass Suspicious for Testicular Cancer & Benign Masses
Diagnosis: 2WW criteria:
- Swelling within the body of the testis
- Testicular cancer – solid mass arising from body of testis.
- Epididymal cyst – separate smooth cystic swelling from epididymis,
- Hydrocoele – smooth swelling, testis impalpable, transilluminates.
- Varicocoele – bag of worms above testis, usually on left. NB. Needs renal USS to exclude renal mass.
Management prior to referral:
Physical examination is often unreliable to differentiate testicular malignancy from other scrotal masses; >90% of current referrals are for benign disease, particularly in men >55y.
**Please confirm the diagnosis with a scrotal USS before 2WW referral,
if confirmed, test serum α-FP, βhCG & LDH**
- If clinical diagnosis uncertain use USS testes to confirm.
- Only needs referral if patient symptomatic and bothered.
- Surgery carries risk of post op haematoma/infection/chronic pain.
- Aspiration of hydrocoeles and epididymal cysts is generally not advocated as usually recur within short period of time and risk causing infection.