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  • Epididymitis or TC

    *Possible Misdiagnosis*
    One week ago I found a lump growing on my epyditimiyis (between the size of a pea to a marble) so close to my left testical that it feels like it's practically attached. The only reason I found the lump was because of a strange tenderness I felt in my testical when sitting one day. It is more or less painless but very tender and uncomfortable. Right now I'm studying abroad in Florence and when I first went to the hospital there were some translation issues and I told them I had pain because I was scared and that's what I thought it was. The doctor sent me to do a testicular ultrasound but I'm not sure the ultrasound technician found the lump because of the language barrier. She checked for hydrocele and other things but I can barely understand the report because it's in medical terms and also in Italian.

    The doctor sent me to see a urologist, he spoke little English but it was enough. He checked my lump and asked if it hurt when he touched it and I said yes even though it was just sensitive and tender. He said it was epiditimytis an he prescribed me 5 days of Levoxacina which is a antibiotic only available in Italy and Portugal usually used to treat UTIS.

    Now I am finished my antibiotics and the marble sized lump has not changed and it is so uncomfortable that I have to spread my legs wide open to sit on a chair comfortably sometimes. I have also had for a few days a pain in my lower back and a strange sensation in my groin. I am so incredibly scared now I can barely sleep, is it possible that they misdiagnosed TC for epididymitis because I told them I had pain when really it was tenderness? Does anyone know how common cancer of the epididymis Is? I understand from the internet that most epididymal lumps are not cancerous but also I understand anything is possible. Im going to go back to the urologist as soon as possible but until then can anyone tell me anything? It's hard getting clear medical advice in a foreign language.

    -I went back to see the urologist about the antibiotics not working and he told me to wait 3 days and continue to take ibuprofen for (swelling) then if the lump stays the same I should go to ER.

    Thank you to everyone in this community.
    Last edited by Braydenraz; 02-06-17, 05:45 PM.

  • #2
    Originally posted by Braydenraz View Post
    One week ago I found a lump growing on my epyditimiyis (between the size of a pea to a marble) so close to my left testical that it feels like it's practically attached. The only reason I found the lump was because of a strange tenderness I felt in my testical when sitting one day. It is more or less painless but very tender and uncomfortable. Right now I'm studying abroad in Florence and when I first went to the hospital there were some translation issues and I told them I had pain because I was scared and that's what I thought it was. The doctor sent me to do a testicular ultrasound but I'm not sure the ultrasound technician found the lump because of the language barrier. She checked for hydrocele and other things but I can barely understand the report because it's in medical terms and also in Italian.

    The doctor sent me to see a urologist, he spoke little English but it was enough. He checked my lump and asked if it hurt when he touched it and I said yes even though it was just sensitive and tender. He said it was epiditimytis an he prescribed me 5 days of Levoxacina which is a antibiotic only available in Italy and Portugal usually used to treat UTIS.

    Now I am finished my antibiotics and the marble sized lump has not changed and it is so uncomfortable that I have to spread my legs wide open to sit on a chair comfortably sometimes. I have also had for a few days a pain in my lower back and a strange sensation in my groin. I am so incredibly scared now I can barely sleep, is it possible that they misdiagnosed TC for epididymitis because I told them I had pain when really it was tenderness? Does anyone know how common cancer of the epididymis Is? I understand from the internet that most epididymal lumps are not cancerous but also I understand anything is possible. Im going to go back to the urologist as soon as possible but until then can anyone tell me anything? It's hard getting clear medical advice in a foreign language.

    -I went back to see the urologist about the antibiotics not working and he told me to wait 3 days and continue to take ibuprofen for (swelling) then if the lump stays the same I should go to ER.

    Thank you to everyone in this community.

    EDIT: I misread what you put at first! Post below mine explains it very well so i'll leave it at that!
    Last edited by Nish115; 02-06-17, 05:16 PM.
    24 year old diagnosed 6/11/16
    Pre/o markers 9/11/16 - HCG 15, AFP 210, LDH 539
    Pre/o CT Clear
    Non-seminoma (80% embryonal carcinoma, 10% yolk sac tumour, 5% chorea carcinoma, 5% seminoma)
    Post-op markers - 14/12/16 - HCG 35, AFP 1050, LDH 430
    Post-op CT with one enlarged lymph node - 1.5x1cm
    Borderline stage 2B/3B
    BEPx3 started 15/12/16 (Borderline BEPx4 - Advise of Dr. E to only do 3 rounds)
    CT and markers clear - in remission - 28/2/16

    Comment


    • #3
      Bongiorno! I spent a little time in Italy at the Universita per Stranieri in Perugia back when I was in college. Toward the end of my stay I got terribly sick and had a very hard time explaining my symptoms to the doctor I saw, both because of the language barrier and I couldn't stop coughing my lungs out. Anyway, it's frustrating to be away from home and sick but you'll get through it. And despite any language issues between you and the doctors, they're still going to know what to look for and aren't going to ignore you if the antibiotics aren't effective.

      Regarding your situation, I'm not an expert at all, but due to my own situation I've been reading on paratesticular masses, which is what you have because the mass is located on or near the epididymis and not within the actual testicle itself. So, basically if the mass was malignant, then it wouldn't be "testicular cancer" but rather a different type of cancer which occurs in the paratesticular region. With that said, masses in the paratesticular area are not super unusual but tumors in the in the region are very rare, and only about 30% of them are malignant. In other words, even if you had a tumor (which is very unlikely) there is a 70% chance it would not be cancerous.

      Now, the tech who performed your ultrasound would have checked your epididymis because they look at all those structures, not just the testicle itself and so it's extremely likely they located and examined the mass. Again, from what I understand, ultrasound is a very reliable way to determine if a mass is a tumor or something like a cyst, because they look much different. What they aren't able to do (from what I understand) is determine the difference between a malignant and benign tumor. In other words, the tech probably saw the mass and was able to make some determinations that lead your doctor to diagnose you with epididymitis. I obviously haven't seen your records, but it's safe to assume that had the tech seen a tumor like mass, they probably would have requested additional testing, such as blood work for tumor markers.

      Again, I understand your anxiety, but at this point I suggest allowing the meds to do their work and if things don't clear up then return to your doctor (or another one) for a second look. Hope that info helps. How long are you staying in Italia? I spent a couple days in Firenze (just before getting sick as a matter of fact) and liked it very much!
      Last edited by Mac; 02-06-17, 02:08 PM.

      Comment


      • #4
        Ciao Mac, thank you for responding so quickly. Yeah it's really tough being away from home and sick, I've been stressing for a week but I'm starting to relax now that I can talk to people about it on here. Thank you for the facts about paratesticular masses the doctors haven't explained to me too much about anything. The urologist told me to wait 3 days and then go back to the hospital but I'm going to go tomorrow anyways to see if someone can explain to me my testicular ultrasound report and hopefully to do another if there was an error because actually today i've started to develope a pain that comes and goes in my right testical (the mass is in the left) which is scaring me. I understand that all the worst thoughts are going to my head and I need to relax, but I can't help but think that if it is TC or a paratesticular cancer, I'm wasting time.

        Florence has been really great and I'm staying here until July then I go back home. My Italian is good enough to communicate with nurses and sometimes to doctors but at the same time I could miss hearing something important without knowing it so I usually try to stick to English. I also visited Perugia for a day and I remember there was a beautiful staircase that went under an acquaduct or something, there's a lot of wonderful towns around that area.

        Anyways I will update this post after I go back to the hospital tomorrow, thank you again for all the information and help.

        Comment


        • #5
          It's difficult to curb the anxiety, I've been having a hard time with that myself. But I've also recognized most of my fears are blown way out of proportion to my situation (e.g. thinking every ache and pain is a symptom). In your case, keep in mind that an infection could certainly cause pain to radiate though both testicles and the rest of the groin. You should also consider that worst case scenario, cancer is highly unlikely to metastasize that quickly and there would still be plenty of time to be treated.

          Do you have a program director or anyone else that you could speak with about your situation or possibly even come along to help translate? I know it's an embarrassing topic to broach but it could be helpful just to have someone there to speak with. Not that my situation was the same as yours, but when I saw the doctor in Perugia, I wish I had brought someone to help translate because I just didn't know the specific words to describe how I was feeling, so the doctor seemed to think I just had a cold (turns out I actuality I had mono).

          Anyway, keep us updated. I don't know if you're the praying type but I am and I'll keep you in them just in case

          Comment


          • #6
            It been pretty well explained above so I won't repeat, all I will add is that in some ways the pain is a good sign because most testicular cancers present as painless lumps or obviously hardenening of the testicle. Combine that with your lump being outside the testicle and I would say the chances are extremely high that this is not cancer but something like an infection or a cyst. Follow the advice above about seeing the Doc again if nothing improves but try not to worry and don't be checking yourself downstairs every few hours as that will increase any swelling and pain.

            Comment


            • #7
              So I went back to emergency and they did a bunch of bloodwork im guessing for cancer/tumour markers. They also thankfully did another ultrasound and during the ultrasound I made sure the technician found the lump. She didn't find it at first then she realized it was the whole epididymis head which was swollen.

              The exact ultrasound document translated from google translate is:
              Examination normal. ECO no alterations of Didim, regular vascularization, epididymis head since increased in size with millimeter cyst. EO: Ndn Council Macladin cpx2 1 x 5 days, subsequent outpatient revaluation.

              They also wrote evidence of ectasia plexus pampiniform which I do not understand.

              so.. I guess its a cyst.. but then I don't understand why they gave me a much stronger antibiotic for more time and a much higher dosage called Claritromicina (in Italian). It's got horrible side effects, nausea, diarrhea, a really horrible metalic taste in my mouth, and I think its killed all the bacteria in my mouth that it's given me Thrush, an oral yeast infection which has seemed to turn my tongue kind of white and given me a bunch of weird white patches at the back of my throat. They did however give me ativan to help with the anxiety.

              If by monday (when I finish the antibiotics) the lump is still the same or bigger then I'm really going to be worried.

              My only worry now is that It is difficult to see a tumour through the epididymis because of what I have been searching online about paratesticular cancers. Anyways they seem to be confident its nothing even though my right testical is becoming just as uncomfortable as my left. The lump on my left epididymis seems to feel much more round and fuller but I have stopped checking it all together today due to the anxiety it gives me. I can't even go pee without thinking about it.

              Does anyone know how long the blood test result could take for them to check for cancer or tumor markers? I cannot seem to find a good answer online of how long it would take.

              Also thank you to everyone who replied. It really helps having people to talk to who can understand.
              And thank you Mac for keeping me in your prayers.

              Comment


              • #8
                In my area, it typically takes a few days to a week (one of the tests takes a few days longer than the others). I imagine that varies from one lab to another though.

                Dave
                Jan, 1975: Right I/O, followed by RPLND
                Dec, 2009: Left I/O, followed by 3xBEP

                Comment


                • #9
                  Man, I'm really sorry you're still having to deal with this. Have your symptoms changed at all? I'm not sure how long it takes to get lab results, I think it could vary greatly depending on the facility.

                  I tried searching some of the terminology. It sounds like the plexus pampiniform are the veins in the spermatic cord and ectasia describes dilation, swelling or inflammation. I've also read that cysts can hide tumors but I think that would be an extremely rare event considering tumors themselves are quite rare.

                  I think you're doing all the right things. I would check back in with them regarding the blood work and let them know if the antibiotics aren't working. Again, try not to worry and remember that paratesticular cancers are extremely rare. I definitely went overboard reading scary case studies and when I brought up various malignancies, my urologist was like, "Dude, you've been reading too much, those don't even apply to your situation!" Anyway, I'm sure your doctors know what they're doing even when it doesn't seem like it.

                  This is sorta off-topic, but maybe it'll help get your mind off things for a moment. I found this old email I sent my wife (girlfriend at the time) when I sick in Italy:

                  I finally went to the pharmacy and bought a thermometer today. I didn't know the word for it so I said something like, "Do you all have something for to measure the temperature of my body?" Once they figured out what I meant, they gave me one of the old kinds with mercury inside, and since it was in Celsius I had to ask, "If I have a fever, what is the temperature?" They explained that 37 is normal and that 38-40 is in the sick zone. So I asked, "If I have 41 I go to medic, okay?" After the pharmacists stopped laughing at me, they informed me that if I had a fever of 41 that I wouldn't be able to use my arms and legs, and certainly wouldn't be able to walk to the pharmacy.

                  Comment


                  • #10
                    Generally my left testical feels the same but now my right one has discomfort. I am not so worried now, I am almost convinced that I have a big Spermatocele. Or it could be a paratesticular lipoma tumor which are usually benign (or it could still be epididymitis). I think I'm going to pop into my urologist's office and ask him about the side effects of the antibiotics and maybe he will lower my dose cus frankly they are making me feel like a pile of pud.

                    That's funny that reminds me of the messages I send my girlfriend every day I go to the hospital or pharmacy and I explain to her everything that happened. She thinks I'm pretty brave going through all this in a foreign country haha. What year did you study in Italy during? I wonder if it has changed a lot since then. And did you cure your mono before going home? That must have been tough, I know my situation has a small possibility that it could be grave but I'm also grateful that physically I feel fine and full of energy(besides the antibiotics). After this scare I think I am going to appreciate the little things more and take better care of myself. I feel like it's such an interruption in my life at this moment I just want all this to go away.
                    Last edited by Braydenraz; 02-08-17, 07:45 PM.

                    Comment


                    • #11
                      Pain is funny (not ha ha funny), I recently had a toothache & while I knew I had a problem tooth in that area & most of the time that's where the pain seemed to be, sometimes it felt like two teeth away & a few time like on the opposite jaw. I honestly could not be 100% that we were treating the right tooth.

                      Dave
                      Jan, 1975: Right I/O, followed by RPLND
                      Dec, 2009: Left I/O, followed by 3xBEP

                      Comment


                      • #12
                        Yes that is very true! The discomfort from my left testical radiates throughout my whole groin. And then there's other times where I can't even feel it at all when I'm not thinking about it.

                        Comment


                        • #13
                          Originally posted by Braydenraz View Post
                          Yes that is very true! The discomfort from my left testical radiates throughout my whole groin. And then there's other times where I can't even feel it at all when I'm not thinking about it.
                          Definitely, pain is so hard to pinpoint and anxiety only seems to amplify the feeling. Were you able to get any info from the urologist?

                          Originally posted by Braydenraz View Post
                          That's funny that reminds me of the messages I send my girlfriend every day I go to the hospital or pharmacy and I explain to her everything that happened. She thinks I'm pretty brave going through all this in a foreign country haha. What year did you study in Italy during? I wonder if it has changed a lot since then. And did you cure your mono before going home? That must have been tough, I know my situation has a small possibility that it could be grave but I'm also grateful that physically I feel fine and full of energy(besides the antibiotics). After this scare I think I am going to appreciate the little things more and take better care of myself. I feel like it's such an interruption in my life at this moment I just want all this to go away.
                          I was there in 2003, which sounds so long ago now! I would guess one of the biggest difference is access to the internet. I don't know what it's like now, I assume modern but at that time the only thing available was some poor old computers at an internet cafe a few blocks from my house that ran on dial-up. When they worked, it cost 5 cents a minute to write emails home, but it was less expensive than buying a calling card to use a pay phone. I did not recover much better before returning home. My wife said she didn't realize how sick I was until I got off the plane looking like a sickly pile of skin and bones.

                          Oh, probably the other big difference was that the US had just invaded Iraq so there was a lot of anti US sentiment. I remember there was some concern about safety but no issues that I recall. And this was pre Amanda Knox, who of course attended the same school in Perugia a few years later. I'm sure things changed after that!

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                          • #14
                            So after doing 11 days of pointless antibiotics the Urologist said that it must be a "cisti" so a cyst but I don't know why they made me do so much antibiotics after the first round didn't work.. They prescribed me Cetraflox everyday for 30 days which supposedly breaks down bodily fluids. I am very weary to take this medication as the Italian doctors seem to be eager to prescribe me anything they can.. They gave me a cortisone shot in my ass for a sore throat! It make me sick. They also prescribed me steroids for my sore throat and more bloody antibiotics without running tests!

                            Mac I feel like I'm following in your footsteps. For the last 3 weeks, I have had a sore throat and last week it got so much worse with swollen lymph nodes and difficulty swallowing. I went to an English doctor finally and he ran a bunch of tests and it turns out I have the Epstein Barr Virus which is the virus that causes Mono. I'm so sick it's horrible I just want to be better already, I feel like a zombie, I now understand what you went through it's not fun
                            Last edited by Braydenraz; 02-24-17, 05:43 AM.

                            Comment


                            • #15
                              Hey, good to hear from you, but dang that sounds really crappy. I searched that Cetraflox stuff and it sounds pretty wacky: Its innovative, original, complete synergy of natural components can be useful for the antioxidant activity.

                              And giving you a cortisone shot for a sore throat?! Glad you were able to find an English doctor. Was he able to give you any better info on your epididymal cyst? Have any of your symptoms improved? Hang in there and hope you start feeling better soon!

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