concerned mom

[mombess]

I am concerned about my son, 29yrs old.
The story starts a month ago when he called me to come pick him to take him to the emergency room. His pain was so bad in his back it took him to his knees. They couldn’t find anything wrong and were sending him home. As he was getting dressed the pain came back and fortunately the doctor was walking into the room as it happened. The doctor asked to check his testicles. He had a swollen left testical, the ultra-sound shows 4 masses, they did some kind of swab test and made an apt with the urologist 4 days later. The urologist couldn’t feel anything, wasn’t concerned. Gave him an anti-inflammatory and told him to come back in a month.
He got a second opinion. That doctor concurs with the first. He also had his us read by a nurse and her staff that works for a urologist at UofM. She suggested the blood marker tests asap.
He had his follow up apt with the first urologist this morning. Can’t feel any lumps. Ultra sound scheduled for Mon, but not thinking of doing the blood tests. Told my son that it is most likely it is epididymitis. Is there not a way to distinguish between this and possible cancer? Are the masses that show up on ultrasound always detectible by touch? Why wouldn’t a doctor just go ahead and order the blood tests? Would there be any other reason spots or masses would show up on the ultrasound? Would epididymitis cause this?
Should he be pushing these doctors for more answers or tests? Or just go with their lack of concern about cancer?

[1lessball2answr]

Hey there,

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.

[Davepet]

Get a copy of the U/S report from his doc & post it here. Someone should be able to make sense of this. If there are 4 solid masses those docs are flat wrong to be unconcerned, but perhaps what was sen were benign cysts?

The U/S report should have the answer.

Dave

[mombess]

Thanks Dave,
I doubt I'll be able to get the report. My son isn't happy with me. He thinks I am overreacting and I should accept what his doctor is saying.
He has another ultra-sound on Monday. Why this office would schedule this appt a month out and not have had a follow up ultra sound BEFORE he went in today is beyond me. Why have an appt today and tell him to go next week for another us when this all started over a month ago.
In this day and age when doctors order multitude of unnecessary tests, I just can't get my head around why they would not just order the blood tests.
Is this cancer that rare that even urologists are unfamiliar?
I really do hope I am over reacting and all this is nothing. It just doesn't feel right, though.
thanks again.
Wishing you the best
Linda

[Fed]

the ultra-sound shows 4 masses

That right there is a red flag. The ultrasound report would indicate whether these masses are solid or fluid filled and if there is bloodflow to them. If the mass is liquid, it's a cyst. If it's solid, 95% of the times it is malignant. The back pain is a bit worrisome, but I should note that in order for retroperitoneal metastases to be symptomatic, they have to be rather large.
[QUOTE=mombess;169826]Are the masses that show up on ultrasound always detectible by touch?{/QUOTE]
Not always, especially if the lesions are inside the parenchyma (i.e. deep within the tissue). It is possible, though, to feel a change in the consistency of the testicle-- something a guy can tell by doing a self exam appropriately.