A 35 year old man with painless left testicular enlargement for the past 6 months which is increasing in size. On examination, the left testicle is noted to be 3 times the size of the right testicle. There is no tenderness or redness. What is the SINGLE most likely diagnosis?
A. Testicular cancer
B. Hydrocele
C. Epididymal cyst
D. Epididymo-orchitis
E. Scrotal haematoma
It is important to note where the enlargement is located. One can mistakenly answer epididymal cyst or hydrocele if one does not read the stem properly. Note that the enlargement (sometimes lump or swelling) is of the testical and not scrotum. If it was scrotal swelling, that you can think of hydrocele or epididymal cyst.
Testicular cancer - Majority of testicular tumours arise from the germ cells.
Testicular germ cell tumours can be subdivided into seminoma and nonseminomatous germ cell tumours however this is unlikely a need to know for this exam. The presentation is the more important information to remember. Presentation - Painless lump in the body of the testis → This is the most common presentation Diagnosis - Ultrasound is first line - CT scan is used for staging - Appropriate tumour markers should be ordered (unlikely you would need to know in detail for the exam)