Testicular mass

What it is

A palpable mass in the testis is a different problem from a scrotum that is acutely painful and swollen, and the first rule about the mass is blunt: palpable tumors of the testes are often malignant. A swelling in the groin or scrotum has a wider list behind it, which holds communicating hydrocele, cystic hydrocele, undescended testis, inguinal hernia and testicular torsion.

The cancers themselves divide by their cell of origin, and each has a histopathology of its own. Seminoma arises in the mediastinum testis, namely the seminiferous tubules, and shows round cells with an acidophilic nucleus and clear cytoplasm. Teratoma arises from the totipotent cells of the rete testis and is a yellow colored cystic tumor engulfed by tunica albuginea. Leydig cell tumor arises from Leydig cells and shows polyhedral cells with hyaline bodies and cytoplasmic crystalloids of Reinke. Sertoli cell tumor arises from Sertoli cells and shows columnar cells with cleft nuclei.

Read as one block, testicular tumor is the most common malignancy in men aged 20-30 years, and most testicular cancers are germ-cell tumors: the seminomas, and the non-seminomas, which are embryonal, yolk sac, teratoma and choriocarcinoma.