Testicular mass evaluation
What is Testicular mass evaluation?
A testicular mass is any lump or swelling found in one or both testicles. These masses can be solid or filled with fluid. Some are harmless, but others can be cancerous.
Blood tests help determine what type of mass is present. Human Chorionic Gonadotropin, or hCG, is a hormone that becomes elevated in certain types of testicular tumors. In males, hCG should be nearly zero. When a testicular mass is present and hCG is elevated, it often indicates a nonseminomatous germ cell tumor. This type of tumor requires specific treatment approaches.
Early detection matters because testicular cancer is highly treatable when caught early. Most men discover a mass through self-examination or during a routine physical. Blood testing with hCG helps doctors classify the tumor type, plan treatment, and track response to therapy. Normal hCG does not rule out cancer, as some tumor types do not raise this marker.
Symptoms
- Painless lump or swelling in one testicle
- Feeling of heaviness in the scrotum
- Dull ache in the lower abdomen or groin
- Sudden collection of fluid in the scrotum
- Pain or discomfort in a testicle or scrotum
- Enlargement or tenderness of breast tissue
- Back pain, especially in later stages
- Difficulty breathing or chest pain if cancer has spread
Many testicular masses cause no symptoms initially. Some men only notice changes during showering or self-examination. Regular self-checks help catch masses early.
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Causes and risk factors
Most testicular masses develop when cells in the testicle begin growing abnormally. Germ cells, which produce sperm, are where most testicular cancers start. Risk factors include undescended testicle, family history of testicular cancer, age between 15 and 35, and being white. Previous testicular cancer in one testicle increases risk in the other.
Not all testicular masses are cancerous. Hydroceles, varicoceles, spermatoceles, and epididymal cysts are common benign causes. Infections and injuries can also create swelling. Any new testicular lump needs medical evaluation to determine its nature and whether treatment is needed.
How it's diagnosed
Diagnosis begins with a physical examination where your doctor feels the testicles for lumps or swelling. Ultrasound imaging shows whether a mass is solid or fluid-filled and helps determine its location. Blood tests check tumor markers including hCG, alpha-fetoprotein, and lactate dehydrogenase.
Rite Aid offers hCG testing as an add-on to help evaluate testicular masses. Elevated hCG in males with a testicular mass confirms a nonseminomatous germ cell tumor component. This information guides treatment decisions and helps predict outcomes. If imaging and blood tests suggest cancer, surgical removal of the affected testicle provides the definitive diagnosis. The removed tissue is examined under a microscope to identify the exact tumor type.
Treatment options
- Surgical removal of the affected testicle, called radical inguinal orchiectomy
- Radiation therapy for certain tumor types, especially seminomas
- Chemotherapy for advanced disease or high-risk tumors
- Active surveillance with regular imaging and blood tests for early-stage disease
- Lymph node surgery if cancer has spread to nearby lymph nodes
- Sperm banking before treatment to preserve fertility options
- Testosterone replacement if both testicles are removed
- Regular follow-up with hCG and other tumor markers to monitor for recurrence
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- Simple blood draw at your nearest lab
- Results in days, not weeks
- Share results with your doctor
Frequently asked questions
Elevated hCG in males usually indicates a nonseminomatous germ cell tumor. This type of testicular cancer produces hCG hormone. Your doctor uses this information to classify the tumor and plan treatment. Normal hCG does not rule out cancer, as seminomas often do not raise hCG levels.
Doctors recommend monthly self-examinations during or after a warm shower. The warmth relaxes the scrotum, making lumps easier to feel. Gently roll each testicle between your fingers and thumbs. Learn what feels normal for you so changes are easier to spot.
No, many testicular lumps are benign. Hydroceles, varicoceles, spermatoceles, and cysts are common noncancerous causes. However, any new lump needs medical evaluation to rule out cancer. Early examination and testing provide peace of mind or catch problems early.
Cancer rarely affects both testicles at the same time. However, having cancer in one testicle increases your risk in the other testicle. Most men with testicular cancer have normal testosterone levels and fertility after treatment for a single testicle.
Treatment depends on the tumor type and stage. Early-stage seminomas may only need surgery and monitoring. Nonseminomatous tumors or advanced disease often require chemotherapy. Your oncologist considers tumor markers, imaging results, and pathology to recommend the best approach.
HCG testing is very accurate for detecting nonseminomatous germ cell tumors. About 40 to 60 percent of these tumors produce elevated hCG. The test helps classify tumor type and monitor treatment response. Serial hCG measurements track whether cancer is shrinking or recurring.
Yes, sperm banking before surgery or chemotherapy preserves fertility options. Many cancer centers offer this service before treatment begins. Most men with one healthy testicle maintain normal testosterone and natural fertility. Chemotherapy can affect sperm production, making banking important.
Testicular cancer has one of the highest cure rates among all cancers. Overall survival exceeds 95 percent. Even advanced testicular cancer responds well to chemotherapy. Early detection and proper treatment lead to excellent outcomes for most men.
HCG has a half-life of about 24 to 36 hours. Levels should drop significantly within days after removing the tumor. Complete normalization usually occurs within 2 to 4 weeks. Persistently elevated hCG after surgery suggests remaining cancer that needs additional treatment.
Yes, regular monitoring with hCG and other tumor markers is essential. Your doctor checks levels every few months in the first years after treatment. These tests catch recurrence early when it is most treatable. Most recurrences happen within the first 2 years.