I will let the other more knowledgeable guys chime in, but your post concerned me -- you say that his u/s showed 4 masses, why wouldn't they move forward with removing the testicle at this point? When my ultrasound showed a solid mass, they removed it immediately because they said 95% of the time when a solid mass shows up in a testicle it is cancer.
That being said, you can also develop benign cysts that they will just leave alone unless they are painful... maybe that's what they're seeing?
I support the idea of getting blood work done, it can usually be an indicator of testicular cancer, but know that TC does not always express itself in the tumor markers. If they all come back normal, it does not rule out TC completely.
I do know that TC is rare and a lot of doctors just don't have experience with it. I went to two doctors who both did exams and sent me on my way before I finally had an ultrasound that showed a mass. Just because the doc doesn't feel anything doesn't mean there isn't something there.
28 years old
New York City, NY
Ultrasound on 1/23/12, I/O on 2/1/12
Classical seminoma, 4.5cm, RT invasion, LVI, no spermatic cord margin invasion.
CT scans clear
pre op bHCG: 57, post op: 2.4
Clear: 5/17/12, 8/23/12
11/29/12 -- CT scan shows 1 enlarged retroperitoneal lymph node 20mmx15mm, stage changed to IIA
12/17/12 - 3/17/13 -- EPx4 @ MSKCC
Clear: 3/7/13, 3/28/13, 5/2/13, 5/30/13, more to come...