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Author9 Posts
  #1

20 year old man presents with painless 2cm nodule in his right scrotum. The nodule is difficult to distinguish from the right testicle and does not transilluminate. There is no additional swelling or lympadenopathy. What is the most likely dx?
A)cryptochism
B)hydrocele
C)scrotal cyst
D)testicular cancer
E)Testicular torsion
F)varicocele







I was having a hard time choosing btwn testicular cancer and cyst. Can someone help me out? Thx
JACK

  #2

The only thing i could find about cysts related to the scrotum would be sebaceous cysts and these would probably be easy to differentiate from the testicle so i would go with E testicular cancer....

  #3

Thx fot the input johnny.....very much appreacitated

  #4

You can get epididymal cysts, but that doesn't seem to be the case here as the mass is off the testis. Obviously the lymph node thing is a red herring as the testis drains to the para-aortic nodes. Only a mass which ulcerates the skin would give inguinal lymphadenopathy. I would agree that testicular cancer is most likely. 2cm is quite a size though - management would also include slapping the guy around the head and telling him to get help sooner next time!


  #5

painless testicular mass--> always cancer till proven otherwise.( Ref: Dr Goljan's Notes)

  #6

Agreed with protalgia, pailess testicular mass is always cancer, remove the sucker , dont do boipsy because it can cause spread to scrotum

  #7

D not transluminant because the fluid in the TV(tunica vaginalis) sac is haemorrhagic.


  #8

wierd, I have never heard that one. I thought we transilumminate to differentiate a hydrocele from a hypoechoic mass. Where did you get that info? is there a link?

Edited by Ancylostoma on 01/13/07 - 12:22 PM

  #9

D







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