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30 y/o with 2 lumps on left testicle, testicle has also shrunk...

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  • 30 y/o with 2 lumps on left testicle, testicle has also shrunk...

    Hi everyone,


    Great to have a supportive forum like this, and I felt there were others who had been in similar situations and/or experts here. Just to let you know, I'm from Wales in UK and refer to my doctor as a GP.

    I'm 30 and I've been having an issue for years where my testicles don't tend to 'hang' much, and stay quite tight no matter what, and more than often more recently, they keep riding up and going back up past my penis. This happens often, but more than often when receiving some sort of sexual stimulation, or even just lying down. Anyway.

    A few weeks ago, I found a pea sized lump towards the top of my left testicle. The lump feels 'attached' and pretty firm. My left testicle has always been a little smaller so I wasn't worried about that. When I kept feeling it, I started to feel an uncomfortable pain. I visited my GP and they said that its completely normal and just my epididymis which can be an abnormal shape. I accepted this.

    Within a week, the pain was a little more noticeable, but more of an ache, so this didn't feel normal. Then a week later, the pain became very uncomfortable, and whenever I moved my legs or gently nudged my groin, the pain was almost agonising. My left testicle was very difficult to touch, and when I did, the pain was excruciating. It felt a little swollen but I'm not sure.

    Saw my GP again, who seemed quite happy and said that its epididymitis which probably hasn't come from an STI (this wouldn't make sense!) but possibly from a UTI or some other source. I accepted and I was put on a week's course of antibiotics. By that time, the pain had subsided a lot, and since then I've just been left with a bit of an ache, however the only pain now seems to occur when I squeeze the lump, despite being firm.

    As the course was finishing, I noticed that there was another firm 'attached' lump of a similar size at the top of my left testicle, but the opposite side. I also noticed that the testicle seems to have shrunk significantly. So today I have just gone back to the GP, but saw a different doctor who would like me to be seen by an oncologist or urologist (not sure which one) with expertise in this area, and to receive an ultrasound. I have been referred but may be waiting up to a month (standard here in Wales).

    At the moment I am just very worried and I don't feel comfortable discussing it with anyone in my network so I'm reaching out here. I can't seem to find another article with an exact same scenario as mine so I was wondering if anyone can relate, shed any light or have anything to say in regards to this?

    I've been told its likely to be something on the epididymis due to the way it forms/connects, and also varicocele. However the connecting veins seem fine.

    Anyway, thanks in advance for any help
    Last edited by PixelGenius; 09-14-17, 06:22 AM.

  • #2
    With those symptoms, it is less likely to be TC, and more likely to be something else. TC usually doesn't present with pain at all, or sometimes very mild pain/ache.

    Please do get an ultrasound though - that will determine if the mass is solid/dense (likely TC), or non-solid/dense (hydrocelle, cyst, inflammation, infection, etc).
    6/5/15: bHCG 27,AFP 8.66, LDH 361, 5.6cm lymph node - Stage IIC
    6/16/15: Left I/O 85% EC, 10% chorio, 5% yolk sac opinion 2 (mayo) 90% EC, 10% yolk sac
    7/7/15: bHCG 56, AFP 42, LDH 322
    7/13/15 - 9/18/15: 4xEP
    10/1/15: bloodwork normal, ct scan shows 2 lymph nodes 1.0cm
    10/26/15: 2nd opinion on CT results - lymph nodes normal. Surveillance!
    4/6/16: 1.7cm X 1.5cm lymph node found with markers normal.
    4/20/16: RPLND @ IU - teratoma only!
    9/18/2017 all clears up to this date!

    Comment


    • #3
      Sorry to hear that you are having these symptoms and having the ultrasound is definitely what I would want to have done. It could be any number of things going on but getting it sorted and making sure it isn't cancer is important. You shouldn't be having pain and there should be a reason for it so hopefully, the ultrasound will be done sooner than later.

      I am not sure if it would help at all but in the UK there are NICE Guidelines on testicular issues that suggest either referral within 2 weeks or direct access to ultrasound:

      Testicular cancer
      1.6.7 Consider a suspected cancer pathway referral (for an appointment within 2 weeks) for testicular cancer in men if they have a non‑painful enlargement or change in shape or texture of the testis. [new 2015]
      1.6.8 Consider a direct access ultrasound scan for testicular cancer in men with unexplained or persistent testicular symptoms. [new 2015]

      https://www.nice.org.uk/guidance/ng1...ogical-cancers

      I've ben up Mt Snowdon a few times and love Wales by the way.

      Keep us posted.

      Mike
      Oct. 2005 felt lump but waited over 7 months.
      06.15.06 "You have Cancer"
      06.26.06 Left I/O
      06.29.06 Personal Cancer Diagnosis Date: Got my own pathology report from medical records.
      06.30.06 It's Official - Stage I Seminoma
      Surveillance...
      Founded the Testicular Cancer Society
      6.29.13 Summited Mt. Kilimanjaro for 7th Cancerversary

      Comment


      • #4
        Thank you both for your replies, I appreciate it!

        I have had a call to confirm an appointment this Thursday (conforms with Nice guidelines as mentioned). It's with a urologist I think. However I am not sure if this will include an ultrasound too. I was advised by my GP that I might have the urologist appointment before the ultrasound, which sounds odd.

        Anyway, since Ive found the lumps Ive been having unusual symptoms which I'm hoping are completely unrelated. I'm feeling very achey and heavy. My legs, particularly my calves are throbbing 24/7 even when resting, and today my neck is very tender and feels bruised. I'm also feeling very sleepy often with a disturbed sleep.

        Anyway, no change with the symptoms I originally described (no further growth which is good). Noticing significant pain in my testicle and groin when I have an erection.

        Will post back any news from Thursday. Thanks again!

        Oh and Mt Snowdon here in Wales is fantastic!

        Comment


        • #5
          Hi again.

          I had my urologist appointment today, and I will have my ultrasound tomorrow morning.

          Unfortunately it's not great news at this point. The urologist was very concerned, he said he has diagnosed and checked a lot of people and can safely say that there is something wrong in the area of my left testicle. He also noticed that I have quite severe abdominal sensitivity which I thought was normal but isn't. He said that he is quite confident that the two lumps are not cysts, but potentially tumours, although needs to see the ultrasound first. He had quite a long discussion with me, explaining that if they are tumours, then they may be benign. He noticed that the left testicle is significantly smaller and is confident that this is testicular atrophy (abnormal shrinkage). He is unsure of the cause, and again can't make a lot of confirmations at this point, but believes the cause may from a previous infection or trauma. He was also concerned with my testicle continuously going 'back in' resulting in me manually pushing it back down.

          I've also had a blood test today, so on Monday morning he has advised I contact his desk first thing to discuss the ultrasound and blood test results to take things from there.

          He seemed quite certain that I will need to have the testicle removed Even if the tumours are benign, he believes that there is something definitely wrong that may cause serious issues in the future. He mentioned that there's a chance I could have the tumours/cysts/whatever they are, treated/removed individually, but they are likely to keep returning and I will likely need surgery every few months, which can happen and is of my own choice. But again, a possibility and needs to see an ultrasound and bloods first.

          I'm really upset today as I was hoping for him to say oh it's just this, it's fine, don't worry about it, or we can sort that and you'll be fine. But instead it was a very worrying appointment today which has disrupted my whole day, and even resulted in me missing a deadline in work which is not good!

          If I have any information from the ultrasound tomorrow I'll post it here otherwise I'll post another update on Monday after having another conversation with the urologist...

          Comment


          • #6
            Hi. I'm in Scotland. Sorry to hear about your news today but let's see what the USS brings?

            I was diagnosed a year ago (not quite, nearly though). At the time the urologist told me after the exam that he was almost positive it was a tumour. The radiologist told me it was a tumour at the end of the ultrasound.

            Hence - surgery was scheduled.

            Please post back and let us know. To help manage your anxiety, ask for feedback at the USS. However, I have to say that not everything you detail is typical of TC. Hope the USS goes well for you.

            Comment


            • #7
              Hey again,

              So I had my ultrasound this morning, and the consultant wasn't happy. He could see the lumps, but didn't discuss them. On the scan, of which he showed me, two significantly large internal masses were clear inside the left testicle, he didn't say what they were exactly, and I guess that's not his job. He said that he hadn't seen two masses like this in one testicle before. But they seem like tumours to me I guess any internal testes mass means the testicle is failing and needs to be removed. He also picked up on the fact that the culprit testicle is particularly small which he also found concerning. He advised I have a CT scan immediately.

              I now have to wait until Monday as suggested when the ultrasound, CT scan and blood test results will be back and the urologist will examine them all.

              It looks like this may be what I'm dreading, but have to wait for a confirmation, I'm going to be on edge all weekend!

              Comment


              • #8
                Originally posted by PixelGenius View Post
                Hey again,

                So I had my ultrasound this morning, and the consultant wasn't happy. He could see the lumps, but didn't discuss them. On the scan, of which he showed me, two significantly large internal masses were clear inside the left testicle, he didn't say what they were exactly, and I guess that's not his job. He said that he hadn't seen two masses like this in one testicle before. But they seem like tumours to me I guess any internal testes mass means the testicle is failing and needs to be removed. He also picked up on the fact that the culprit testicle is particularly small which he also found concerning. He advised I have a CT scan immediately.

                I now have to wait until Monday as suggested when the ultrasound, CT scan and blood test results will be back and the urologist will examine them all.

                It looks like this may be what I'm dreading, but have to wait for a confirmation, I'm going to be on edge all weekend!

                Sorry man. If they found solid masses in the testicle you're at over 90% odds that it is testicular cancer. I had a similar experience back in April. Though to be honest, it's kind of weird that they're doing the CT scan first. I think they should get you in quickly to remove the testicle. Before the surgery they will probably draw some blood to measure your tumor markers. This could help determine what kind of cancer it might be (if it is cancer) seminoma vs non seminoma. There are instances where both seminoma and non may not be flagged on a blood test.. You really have to wait for pathology to confirm everything to know what steps you should be taking moving forward. Good luck to you and keep us posted!
                April 2017 - Scheduled physical with DR for testicular pain / ultrasound scheduled
                May 2017 - US shows 3 solid masses 1.2 x 0.7 x 0.7 cm/0.8 x 0.5 x 0.8 cm/ 0.4 x 0.3 x 0.4 cm
                June 2017 - Left orchiectomy & diagnosed with Seminoma
                As of October 2017 - All clear!

                Comment


                • #9
                  Hey Bud, good luck today. Keep us posted. If it is cancer, remember that it's not automatically the end of the world. There will be quite a journey ahead for you, but you're not alone and while it's probably good to mourn some, you don't have to despair. Let us know what happens!

                  Comment


                  • #10
                    Hey again,


                    OK so I had a call from the urologist today. The ultrasound displayed unusual masses, but they believed that they did not have the traditional appearance of tumours, and appeared vascular (not quite sure what vascular means or suggests here though?). The CT scan display nothing unusual, so if anything is there it hasn't spread, despite having some abdominal and leg pain recently. However, the bloods show slightly elevated tumour marker levels. He said they were not significant, but slightly elevated.

                    After his examination last week of which he was very concerned with the shape, size and lumps, as well as my pain, and now with this information, despite not having a confirmed tumour diagnosis, he wants me to have the testicle removed (surgery in approx 2 weeks time). He advised that it will be examined and I will have a meeting about 2 weeks later to discuss the findings from the removed testicle.

                    I expressed my concerns, but he advised me that this was a preventative measure above all because there is still a chance that there could be cancer or similar in my body, or could develop. He suggested that if I find that I have cancerous cells in my body at a later date, I will already have taken the best measure and eliminated the most potential source. Whereas if I don't remove it, not only will I still have to put up with the pain and discomfort, but things could worsen, and of course if cancer is detected at a later date, then I will regret not removing it.

                    He mentioned a prosthetic testicle, which I feel that I really want to assist with my self esteem, but he did not want to add one on the day of surgery, and recommended I wait until 6 months to a year afterwards to ensure that there are no tumours and no chemo would be needed. He advised that if I do need chemotherapy, a prosthetic testicle could cause problems.

                    What do you all think of this?

                    Of course I was really hoping that it would be nothing to worry about and my testicle would heal and could be left alone. But then I certainly don't want cancer. It's a horrible thought that perhaps my testicle is actually salvageable and fine, and doesn't actually need to be removed. Of course right now my left testicle is nowhere near healthy...

                    Comment


                    • #11
                      Well, if it were me, I'd want it out. Based on what you've said, sounds likely to be positive for cancer, & even if it's not, problems like that rarely just heal up.

                      Pretty sure your doc is flat wron on the fake one, most guys get that done at the same time to avoid an additional surgery, chem has no effect on a fake testicle and there is no way chemo will be more problematic. You doc seems to have a bias against the prosthetic, actually. If younwant one, I would insist it be done during the I/O surgery.

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

                      Comment


                      • #12
                        As it was explained to me before my op, there was a small extra risk of aquiring a post-surgical infection when a prosthetic was inserted and that such an infection could cause the start of any necessary chemo to be delayed until it was sorted. It wasn't a case of saying don't put in a prosthetic, just a small part of the info I was given.

                        Comment


                        • #13
                          Thanks for your replies guys. I've arranged to have an initial face to face meeting with the urologist on Thursday to discuss everything in detail. I have a lot more questions to ask, and I would like to take home some figures/stats. If anyone has any advice on things I should ask please let me know

                          So I think the prosthetic would be quite an important option for me, I feel that it would definitely impact my self esteem, and possibly for the rest of my life. I'm concerned that if I had one put in after a few months to a year, then I would of course have to have another op, but would also need to open up the wound again, causing further scarring, or even another wound/scar.

                          If I could have one put in during the orchiectomy I'd be much happier. But there still seems to be so much debate with this and I'm confused on what's best to do. Davepet and MarkOne, did you have any prosthetics added and what was your experience? Have there been any or many reports on issues with prosthetic testicles that I should be concerned with? I'm not too worried about the feeling and I actually think it will make me feel and look better than before as my left testicle was never quite right anyway!

                          Comment


                          • #14
                            In my case, my urologist recommended that I didn't have a prosthetic put in during my I/O, but was also very clear that it was my decision in the end. The main reasons were risk of infection, and the fact that (here in Sweden, at least) 25% of guys who decide to get a prosthetic want to have it removed within 2 years. It seems to me like you're much more concerned about having two "balls" than I am, but I decided to not have one put in. I'd rather wait and see what it's like, and then, after 6-12-24 months or whatever, decide whether I want one or not.
                            It's only been 5-6 weeks since my I/O, and while I'd rather have two balls than one, just having one is definitely the end of the world for me.
                            To be honest, do what you feel is best for YOU. It seems your quality of life would take a huge hit if you don't get a prosthetic, and in that case, it might be worth it.

                            Comment


                            • #15
                              Pixel genius

                              I decided not to have a prosthetic but it is a very personal choice taken at a time when we are feeling vulnerable anyway so only you can take that decision and if it's important to you that you see a pair then go for it. I think I have responded to you on the MacMillan forum too. I wasn't concerned about the look. Only my wife gets close enough to see that area in detail anyway and she wasn't worried. I actually prefer the feel of only having one - no painful knocking together or catching in jeans.

                              Comment

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