A 22-year-old male patient recently noticed swelling of the right testicle. He reports a feeling of heaviness and a dull ache in the testicle

Question

There is no history of recent trauma. Physical examination reveals enlargement of the affected testicle, which is firm. The right scrotum is erythematous, and inguinal lymph nodes are palpable. It is important to recognize these are signs and symptoms of:
A. Varicocele of the testes
B. Testicular cancer
C. Hematocele of the testes
D. Torsion of the testes

Answer 1

ANS: B
Malignant tumors of the testes are uncommon, but usually present between the ages of 15 and 35, are slightly more common on the right side, and arise from germ cells. A patient may have noticed a painless swelling of the testicle or a distinct nodule on self-examination. Minor trauma may have occurred to the affected side and initiated the onset of pain and/or swelling. The testicle gradually enlarges over time, with some associated heaviness. Patients usually complain of a dull ache or heaviness that localizes to the affected side. Physical examination reveals a distinct mass or diffuse enlargement of the affected testicle; the mass may be firm, smooth, nodular, or fixed; and the scrotum itself may feel warm and be erythematous. Palpation of the inguinal, supraclavicular, and axillary areas may show evidence of enlarged lymph nodes.