Overview

Testicular masses, sometimes called testicular or scrotal lumps, are abnormal growths or swellings that can develop in or around the testicles. These masses can be benign (non-cancerous) or malignant (cancerous) and vary in size and consistency. While most scrotal masses are not cancerous, any abnormal lump in or around the testicles should be evaluated by a healthcare provider promptly to determine the cause and appropriate treatment.

The understanding and management of testicular masses have evolved considerably over the decades. Historically, testicular masses like tumors were often identified at later stages due to limited access to advanced diagnostic tools. The development and widespread use of ultrasound technology in the 20th century marked a significant advancement in the early detection and characterization of scrotal masses. The introduction of tumor markers and advanced imaging techniques has further enhanced the ability of healthcare providers to diagnose and manage both benign and malignant testicular masses.

Early surgical interventions often involved an exploratory approach, but with advancements in medical knowledge and surgical techniques, more precise and less invasive procedures are now standard. The understanding of the molecular and genetic basis of testicular cancer, which includes identifying risk factors and genetic predispositions, has aided in preventative measures and targeted therapies.

Causes

Testicular/scrotal masses can be caused by a variety of conditions, including:

Testicular Cancer: Malignant tumors of the testicle. Testicular cancer is relatively rare but is the most common cancer in young men aged 15-35.

Epididymitis: Inflammation of the epididymis, often due to infection, which can cause painful swelling.

Hydrocele: Accumulation of fluid around the testicle, leading to swelling.

Varicocele: Enlarged veins within the scrotum, similar to varicose veins in the legs.

Spermatocele: A cyst that develops in the epididymis and contains fluid and sperm cells.

Inguinal Hernia: Part of the intestine protrudes through a weakness in the abdominal wall into the scrotum.

Risk Factors

Several factors can increase the risk of developing testicular tumors:

  • Age: Testicular cancer is most common in young adults and middle-aged men.
  • Family History: A family history of testicular cancer can increase risk.
  • Undescended Testicle (Cryptorchidism): Men who had an undescended testicle are at higher risk for testicular tumors.
  • Previous Testicular Cancer: Having had cancer in one testicle increases the risk in the other.

Complications

If left untreated, some scrotal masses can lead to complications, depending on the underlying cause:

Infertility: Conditions like varicocele and infections may affect fertility.

Spread of Cancer: If the mass is cancerous, it can spread to other parts of the body.

Chronic Pain: Persistent pain and discomfort.

Infection: Untreated infections can lead to abscess formation and systemic illness.

Prevention

While not all testicular masses can be prevented, early detection through regular self-examination and medical check-ups is crucial:

  • Self-Examination: we recommend adolescents perform monthly testicular self-examinations to detect any changes or lumps early.
  • Regular Check-Ups: Routine visits to a healthcare provider for physical exams.
  • Awareness of Risk Factors: Understanding personal risk factors and discussing them with a healthcare provider.

Symptoms

When to see a doctor