Testicular cancer is most commonly a germ cell testicular tumor, which accounts for about 85% of all testicular tumors. Most men with testicular cancer are diagnosed early, before the cancer has spread outside of the testicle. Some men will have associated symptoms and seek medical care, whereas other men may have a lump on the testicle that they feel (palpate) or because one testicle appears or feels larger than the other.
Abnormalities in the scrotum that can be felt (are palpable) are not always due to cancer but can be caused by a variety of other disorders. Diagnosing palpable scrotal abnormalities begins with a complete clinical history and physical examination, generally followed by imaging tests.
For individuals with newly diagnosed palpable scrotal abnormalities, with or without a history of trauma or infection, ultrasound duplex Doppler of the scrotum or ultrasound of the scrotum is usually appropriate. These imaging tests are equivalent alternatives, meaning only one is done. MRI pelvis (scrotum) without and with intravenous (IV) contrast and MRI pelvis (scrotum) without IV contrast may also be appropriate.