A 33-year-old male presented to the Emergency Department with one week of right testicular swelling. He endorsed some aching and swelling. He denied dysuria, testicular or abdominal pain, nausea, vomiting, drainage, redness, or itching. He also denied a prior history of sexually transmitted infection and prior similar symptoms,
Genitourinary: Non-erythematous, non-edematous, dense right testicle – significantly heavier and larger than left testicle; no signs of trauma or hematoma
White blood cell (WBC) count: Within normal limits
Urinalysis: Negative
HCG: Negative
AFP: Negative
This is a testicular ultrasound demonstrating an asymmetric right testicle when compared to the left.
The heterogeneous pattern is strongly suspicious for neoplasm.
Take-Home Points
- Testicular cancer is on the differential for testicular swelling and is common in 3rd decade of life.
- When performing a testicular ultrasound, obtain static images with color flow and then repeat images scanning through the testes.
- Provide multiple sources of urological follow-up. This patient received radical orchiectomy just two days later.
- Benson CB. The role of ultrasound in diagnosis and staging of testicular cancer. Semin Urol. 1988 Aug;6(3):189-202. PMID: 3072643.
- Marth D, Scheidegger J, Studer UE. Ultrasonography of testicular tumors. Urol Int. 1990;45(4):237-40. doi: 10.1159/000281715. PMID: 2163557.
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