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48 yr old with a lump

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  • 48 yr old with a lump

    I found a small solid feeling mass (size of a small grain of rice) that seems to be ON the lower rear of left testicle a couple of weeks ago. I went to a urologist to have it checked out and he couldn't find it for a while and then told me he felt something that he thought was a epididymis cyst and told me not to worry about it. Not knowing my anatomy, I went home to look up where the epididymis is and didn't think what I felt was up in that area. So I decided to go to another urologist to get a second opinion and he felt it pretty quickly and ordered an unltrasound which I did right away . The ultrasound came back with a sebaceous cyst which I believe is a cyst of the scrotal skin which doesn't seem to match the clinical diagnose. The urologist doesn't think so either and ordered a blood test to test for tumor markers and an MRI of he testicle (not anywhere else) to further assess the lump. The MRI is NOT to test for metastasis. He said from his experience of feeling for testicular mass that he is concerned. I haven't done the blood test or the MRI test (they have been scheduled for later this week.). This is probabalt a dumb question but how much concern should I have ? I guess I'm not too old to have this kind of cancer. Just asking for any opinion from those who have experience with this. Thx much.

  • #2
    Hi Acf,
    No, your not to old for this type of thing - sorry! Someone else will come in on this, but usually the ultrasound is classed as the "gold standard" for initial diagnosis. If the ultrasound says it is/looks malignant then it probably is. So the converse is also true, if the ultrasound comes back with a cyst, then it probably is.

    From my own experience, my first TC was misdiagnosed several (three I think) times before my ultrasound! So I am not convinced a GP can tell from "feeling" whether it is/is not a tumour.

    You could go for a second ultrasound from a different agency?

    Jan 2009: RHS (Seminoma) & RT
    Mar 2010: LHS (Embryonal Carcinoma)
    Sep 2010: Relapse & 3 x BEP
    Mar 2015: Five years "nut free"
    http://doublezeroami.blogspot.com

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    • #3
      thanks Doulezero. Hope all is well with you now. The doctor is actually a urologist and he mentioned to me he was concerned about the mass. He ordered an US and it was essentially inconclusive. But even before the ultrasound, he said regardless of what the outcome of the US was, he was going to order tumor marker blood test and an MRI based on what he felt and his experience with testicular masses. That's what got me worried....
      Last edited by Acf53; 08-30-17, 03:29 PM.

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      • #4
        Sadly, not too old for TC if that is what you have. You will know more after blood work and scan. Keep us updated.
        17 year old son Grant dx 12/21/16
        pre/o markers 12/21/16- HCG:1065.15,AFP:298.8,LDH:1119
        pre/o CT Scan 12/22/16 normal
        r/o 12/22/16
        Post r/o Elevated Markers with INCREASE 4 weeks post r/o;
        PATHLOGY: mixed maligent germ cell 8.6 x 6.2 x 5.9 cm

        -80% Embryonal, 10% Yolk Sac, 5% Teratoma, 5% Choriocarcinoma w/LVI within Spermatic Cord and invasion into Rete Testis
        2nd CT scan on 1/24/17 3 nodes 2 over 2.5, one over 3.5
        BEP x 3 1/27/17
        Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
        2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
        Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.

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        • #5
          That's strange because my urologist was very clear from ultrasound that it's testicular cancer... He said it's obvious when it attached internally to the testicle, that's the dead giveaway. I know it's weird, but it might pay to try another urologist? No one has to know, you're getting a second opinion...

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          • #6
            Will do Trekga.

            Joe, perhaps the mass is so small that the US actually missed it and saw something else ? The technician surmised that it was a scrotal cyst which my urologist disagreed with essentially. Hopefully the MRI will clear things up and I'm hoping it comes back as a cyst. Had my blood test today and should get the results by late tomorrow or Friday.

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            • #7
              From my research, I came across something called tunica albuginea cyst which kind of sounds like my condition. Complete speculation on my part - hopefully it's just that.....

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              • #8
                Got my blood test results back. AFP and HCG normal. At least I know I prob don't have non-seminoma which I believe is less common in people my age. Going for MRI later today...

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                • #9
                  First, lack of blood markers tells you absolutely nothing. every tumor type can be present & not elevate markers. Only the presence of markers is useful (and dropping markers that were once elevated).

                  Your doc is basically second guessing the U/S results. While the U/S *can* be wrong, it is very rare. I wouldn't be too concerned at this point.

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

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                  • #10
                    I got my MRI results today and it showed nothing according to the report. My urologist did a physical exam again and the hard lump is still there and he still thinks it's on the testicle. This is definitely good news but it's puzzling to me and the doc that the MRI showed no irregularities but there's clearly a lump there. He tried to call the radiologist to review the scans together but was unable to reach him. He said he will let me know once he talked with the radiologist what the next step is. He did say the only real sure way is via operation to inspect. I certainly don't want that. He said the other option is monitor it very closely - doctor exam every few weeks and perhaps another US or MRI - this can be a pain in the butt but I guess it's better than surgery.

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                    • #11
                      Got a call from my urologist today. He looked over the MRI with the radiologists again and saw nothing. So at this point, their recommendation is they will closely monitor me every few weeks. I hate not having anything definitive and have to worry about the possibilities. Guess not much more I can do at this point. I'm just baffled by the MRI scan not showing anything when there's clearly some thing. Makes no sense other than the MRI is not sensitive enuf to pick up these things. I'm not a hypochondriac but I've been feeling a faint ache/discomfort my lower back/groin area. Prob unrelated and I've never mentioned it to the doc.

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