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Clinical Summary

In testicular tumor, a painless, firm testicular mass is palpated, with the patient often complaining of a “heaviness” of his testicle. If the patient presents early, the mass will be distinct from the testis, whereas later presentations will have generalized testicular or scrotal swelling. These lesions occasionally present with pain due to infarction of the tumor.

Management and Disposition

Refer patients promptly to a urologist for definitive diagnosis and management.

FIGURE 8.15

Testicular Tumor. This painless left testicular mass is highly suspicious for tumor, as proved to be the case in this patient. (Photo contributor: Patrick McKenna, MD.)

Pearls

  1. Acute hydroceles and hematoceles should prompt the physician to consider a tumor as the cause.

  2. Pain from tumor infarction is usually not as severe as pain due to torsion or epididymitis.

  3. Findings of an unexplained supraclavicular lymph node, abdominal mass, or chronic nonproductive cough resistant to conventional therapy should prompt a testicular examination for tumor.

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