25. Scrotal Mass Flashcards
What details of a scrotal lump should you find out?
Is it painful? How long has it been there? What made them first notice the lump? Is the lump always there? Any other lumps? Other symptoms? (UTI/STI) Trauma to the testes?
What are 4 key characteristics of a scrotal mass that will let you narrow your differential?
Can you get above it?
Can you palpate the testis separate from the swelling/ lump?
Does it transilluminate?
Is it tender?
What would you suspect if the scrotal mass is separate from the testis, fluctuant and transilluminable?
Epididymal cyst
What would you suspect if the scrotal mass is separate from the testis, non transilluminable and tender?
Acute epididymitis
What would you suspect if the scrotal mass is not separate from the testis and is transilluminable?
Hydrocele (collection of fluid in tunica vaginalis)
What would you suspect if the scrotal mass is not separate from the testis, not transilluminable and tender/ not tender?
Tender: Torsion, orchitis, epididymo-orchitis
Non tender: cancer
What is indicated by an acutely swollen and tender scrotum that has been present for a matter of hours?
Testicular torsion until proven otherwise
What is suggested by a feeling of heaviness in the testis?
Testicular cancer
What should you suspect in a swelling that extends into the groin?
Inguinoscrotal hernia
can’t get above it
What does transillumination of a mass suggest?
Fluid contents
What would you suspect if the scrotal mass is separate from the testis, non transilluminable and non tender?
TB epididymitis
Where do the testes drain?
Para-aortal lymph nodes
Where does the scrotal skin drain?
Inguinal lymph nodes
Which tumour markers are commonly expressed in teratomas?
a-Fetoprotein (AFP)
b-HCG
Which tumour markers are more often raised in seminomas?
b-HCG
LDH
