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JAMA PATIENT PAGE | Men’s Health
Testicular Mass
Testicular self-examinations are best performed in the shower
and are the most common way testicular masses are found.
If you feel something different than usual or you are concerned, see
your doctor. There are many reasons for testicles to swell, hurt, or
have changes on or around them. Some of these may be from benign (noncancerous) causes such as hydrocele (fluid around the testicle), varicocele (dilated veins around the testicle), or a cyst, while
other reasons may be more worrisome. A medical professional can
help determine the cause; a checkup should not be delayed.
Bladder
Penis
Male pelvic anatomy
The testicle is the male
reproductive organ that makes
sperm. Lumps, swelling, pain,
or other changes in the testicle
have many different causes.
Prostate
Rectum
Vas deferens
Epididymis
Testicle
Tests for Testicular Masses
If uncertainty exists about what is felt on the testicle or in the scrotum, your doctor may order an ultrasound (noninvasive imaging
using sound waves) to detect abnormalities inside the scrotum or
the testicles. Blood and urine tests may also be useful.
What Happens if a Mass Is Found?
If a mass is found within the testicle, one of the potential causes is
testicular cancer. Testicular cancer is the most common cancer
among young men and is one of the most curable types of cancer.
The standard of care when testicular cancer is suspected is to remove the affected testicle in a procedure called an orchiectomy—an operation done through a small incision in the groin or
lower abdomen. It is typically performed as outpatient surgery with
a recovery period that can involve 2 to 4 weeks of lighter activity.
Types of testicular masses
Hydrocele
Varicocele
Dilated
testicular
veins
Fluid-filled
sac around
testicle
Scrotum
Testicular cancer
Epididymal
cyst
Fluid-filled sac
above or
behind testicle
Tumor
Treatment After Testicle Removal
Additional treatment depends on staging (determining the extent
of any cancer spread). Staging for testicular cancer is based on
• What is found in the testicle by microscopic evaluation
• Elevation of serum tumor markers (blood tests measure if certain
proteins are at higher than normal levels in the body)
• Abnormalities on body imaging that suggest spread of cancer
outside of the testicle
Depending on what is found in those 3 evaluations, additional
treatmentmayincludecontinuedmonitoringwithimagingtests(called
surveillance), radiation therapy, chemotherapy, or additional surgery. Your doctor will discuss the specifics of any additional necessary treatment, including the risks and benefits of each.
ever, it is important to discuss your family planning goals with your
surgeon before an orchiectomy because sperm banking is an important consideration before any treatment. Some men prefer the
cosmetic appearance of 2 testicles, and a testicular prosthesis can
be inserted at the time of surgery if this is desired.
FOR MORE INFORMATION
American Cancer Society
www.cancer.org/cancer/testicularcancer/detailedguide
/testicular-cancer-signs-and-symptoms
A JAMA Patient Page on testicular cancer was published in the
February 13, 2008, issue.
Living With Only 1 Testicle
Men with a normal remaining testicle after orchiectomy typically have
minimal issues with fertility or male hormone production. HowAuthors: Richard S. Matulewicz, MD, MS; Joshua J. Meeks, MD, PhD
Conflict of Interest Disclosures: All authors have completed and submitted the
ICMJE Form for Disclosure of Potential Conflicts of Interest and none were reported.
Source: Neoplasms of the testis. In: Campbell MF, Walsh PC, Wein AJ. Campbell-Walsh
Urology. 10th ed. Philadelphia, PA: Saunders Elsevier; 2012:837-870.
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(Reprinted) JAMA August 2, 2016 Volume 316, Number 5
Copyright 2016 American Medical Association. All rights reserved.
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