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Noticed Lump On Testicles. Scan Report Says Simple Cyst And Mass Appears Hypoechoic. Meaning?

Posted on Sun, 23 Jun 2013

Question: I am 73. In 1991 I discovered a lump on left testicle. The Dr. excised the lump found it to be benign and sent me home. A few weeks ago I discovered another abnormally in the left scrotum. I went to the urologist who thought it to be Varicocele but to be sure they sent me for ultrasound. FINDINGS: Right Testicle: A simple cyst measuring 1.04 x .84 x .53 cm. Right epididymis: a simple cyst on the head measuring 4.3mm. Left Testicle: a solid mass is visualized measuring .42 x .57 x .35cm. The mass appears Hypoechoic. Scrotal Sac: V aricoceles visualized in left Scrotal SAC. The largest measuring 2.4mm in diameter. The dr. seems to think everything was o.k. with nothing to worry about but tumor markers were ordered. (AFP, B-HCG, and LDH). All tests were normal. What do you think? Is it because the mass is so small and should it be watched with another Ultrasound in the future. or should the mass be excised and the mass tested. By the way I do not know what kind of mass or lump the 1991 was since the records have been destroyed. Thanks

Answered by Dr. G.Srinivasan (3 hours later)

Welcome to the forum.
I went through your detailed history .
Three options are available.
1. Followup scan as your doc suggested .
2. Fine needle aspiration of the mass if technically possible .
3. Open removal of the mass or the whole testis. And examination under the microscope .
I personally prefer the second as it is simple and also gives information about the mass.
Hope this helps .
Best regards

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. G.Srinivasan (34 hours later)

Thank you. I just had a thought. As far as I know the Dr. who read the ultrasound did not know that I had a lump removed from the left testis in 1991. Could it be that what he thought was a hypoechoic mass is in reality scar tissue for the 1991 removal of a lump. Would be worth looking into don't you think or maybe there would not even be any scar tissue and if so maybe it would not look like a hypo mass. Appreciate your advise before a make a fool of myself. Thanks.

Answered by Dr. G.Srinivasan (1 hour later)

welcome back.
Scar usually looks different from a mass.
The mass mentioned is about half a cm, which is too small to be of serious consideration, at your age.
To play safe, it is worthwhile doing a needle biopsy or a open biopsy.
Best regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar