Finding a small lump on a testicle is understandably concerning, often leading to anxiety about serious health issues. While any new lump requires prompt evaluation by a healthcare provider, the vast majority of these masses are not cancerous. Testicular lumps are common and usually stem from benign, treatable causes like fluid accumulation or inflammation. Consulting a medical professional is the only way to accurately determine the nature of the lump and ensure proper management.
Common Non-Cancerous Explanations
The scrotum contains structures beyond the testicle, and irregularities in these surrounding tissues are the source of most lumps. These masses are generally separate from the testicle, which helps differentiate them from cancerous growths. Recognizing the characteristics of these common benign conditions provides context before a medical consultation.
A spermatocele, also known as an epididymal cyst, is a common, typically painless, fluid-filled sac. This cyst forms near the top or behind the testicle, originating in the epididymis, the coiled tube that stores and transports sperm. The lump often feels smooth, soft, and separate from the testicle.
A hydrocele is a frequent cause of scrotal swelling, involving an accumulation of fluid within the thin sheath surrounding the testicle. This condition usually results in a painless swelling that can make the testicle feel like a small water balloon. Transillumination, where a light shines through the scrotum, often confirms a hydrocele because the light passes through the fluid collection.
A varicocele is a cluster of enlarged veins within the scrotum, resembling varicose veins. It is often described as feeling like a “bag of worms” and is most common on the left side. Varicoceles may cause a dull ache or a feeling of heaviness. The swelling often becomes more prominent when standing, sometimes decreasing when lying down.
Inflammatory conditions, such as epididymitis and orchitis, can also present as painful lumps or swelling. Epididymitis is inflammation of the epididymis, usually caused by a bacterial infection, potentially including a sexually transmitted infection. Orchitis involves inflammation of the testicle itself, often due to a viral infection like mumps or a bacterial infection. These infectious causes are accompanied by acute pain, tenderness, redness, and sometimes systemic symptoms like fever, distinguishing them from slow-growing, painless masses.
Recognizing the Signs of Testicular Cancer
While most lumps are benign, a small lump on the testicle can be the first sign of testicular cancer, a highly curable condition when detected early. The presentation of a cancerous mass differs from fluid-filled cysts or inflamed structures. A malignant tumor usually presents as a hard, firm lump or an area of hardness within the testicle itself, rather than being separate and movable next to it.
The lump is often painless, which can delay seeking medical attention, though some individuals experience discomfort or a dull ache in the testicle or lower abdomen. The affected testicle may also feel heavier than normal, or a change in its size or shape may be noticeable. A cancerous mass is fixed and does not move freely away from the testicle.
Certain factors can increase the likelihood of developing testicular cancer, though the exact cause remains unclear. The primary risk factor is cryptorchidism, or an undescended testicle, where one or both testicles fail to move into the scrotum before birth. Other factors include a family history of the disease and age, as it is the most common cancer in men between 15 and 35. The five-year survival rate for localized testicular cancer is high, emphasizing the importance of timely medical review.
What to Expect During Medical Evaluation
If a new lump or any change is discovered, the first step is to schedule an appointment with a healthcare provider. Before the appointment, performing a simple self-examination can be helpful. This is ideally done after a warm shower when the scrotal skin is relaxed. Gently examine each testicle individually by rolling it between the thumb and fingers, noting its normal smooth and firm consistency.
Upon presentation, the physician will perform a physical examination to feel the size, location, and consistency of the lump. The doctor determines if the mass is located within the testicle or in the surrounding structures, and if it is soft, cystic, or solid. This hands-on assessment provides initial clues for differentiating a benign cause from a potentially solid tumor.
The primary diagnostic tool used to investigate a testicular lump is the scrotal ultrasound, a non-invasive, painless procedure using sound waves to create images of internal structures. Ultrasound is effective at distinguishing between a fluid-filled mass, such as a hydrocele or spermatocele, and a solid mass, which raises suspicion for cancer. The ultrasound also indicates whether the mass is inside the testicle itself, a strong indicator of a cancerous growth.
In addition to imaging, blood tests are often ordered to check for specific proteins known as tumor markers. The levels of alpha-fetoprotein (AFP), human chorionic gonadotropin (HCG), and lactate dehydrogenase (LDH) can be elevated by certain types of testicular cancer. While elevated markers do not definitively confirm cancer, they provide evidence to guide further action. If an infection is suspected, blood or urine tests may also be used to check for infection indicators.
It is important to seek immediate care if any lump is accompanied by sudden, severe pain, or if the pain is continuous and worsens. This combination of symptoms could indicate testicular torsion, a medical emergency where the spermatic cord twists, cutting off blood supply. Understanding these urgent symptoms ensures that necessary, time-sensitive medical intervention can be provided.