Scrotal mass overview
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Scrotal mass overview On the Web |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Niloofarsadaat Eshaghhosseiny, MD[2]Sujit Routray, M.D. [3]
Overview
Scrotal mass may be classified into two subtypes: testicular and extratesticular.Scrotal masses may be differentiated according to clinical features, laboratory findings, imaging features, histological features, and genetic studies from other diseases that cause testicular mass with discomfort, back pain, abdominal discomfort, or abdominal mass. If there is an acutely painful scrotum,there should be a strong suspicion for testicular torsion, which is an emergency condition, and emergent surgical referral should be strongly considered.Sonography may be performed if testicular torsion is not suspected to confirm the diagnosis. According to the TNM classification and stage groupings, there are 3 stages of testicular cancer based on the size and extent of the primary tumor, number and location of any regional lymph nodes (abdominal retroperitoneal) infiltrated by tumor cells, distant metastasis, and serum tumor marker levels.Symptoms related with scrotal mass will vary, depending on the cause of the mass, which include enlarged scrotum, painless or painful testicle lump, and feeling of heaviness in the scrotum. Common physical examination findings of scrotal mass include a tender mass which is having a smooth, twisted, or irregular shape and liquid, firm, or solid in consistency. The ipsilateral inguinal lymph nodes may be enlarged or tender.The laboratory findings related with scrotal mass may vary, depending on the cause of the mass.Laboratory findings consistent with the diagnosis of testicular tumors, may include elevated serum tumor markers such as AFP, LDH, or HCG. Imaging studies for scrotal mass include scrotal ultrasound, MRI, and chest x-ray.Biopsy should be performed in patients with scrotal skin lesions to rule out skin cancer.
Historical percpective
Classification
Scrotal masses are divided to two main group:Extra testicular and Testicular.Also scrotal masses may be pain full or not painfull.The other classification is based on neoplastic or non-neoplastic masses.
Pathophysiology
Causes
Scrotal masses may be caused by tumors,injury,truma,infection.Also the causes deponds on anatomical origin.
Differentiating scrotal masses from Other Diseases
Scrotal masses must be differentiated from other diseases that cause scrotal swelling,scrotal pain,such as testicular tortion ,epididimitis,testicular tumors,inguinal herniation and many other diseases.
Epidemiology and Dermographics
Testicular cancer is a rare type cancer accounting about 0.5% of all new cancer cases in U.S. In 2018, the estimate prevalence of testicular cancer is approximately 9,310 new cases of testicular cancers in the United States. The incidence of testicular cancer is approximately 5.7 per 100,000 men per year based on 2011-2015 report in the United States. The majority of cases are reported in New Zealand. Testicular cancer commonly affects more white males than any other races and black males are less affected by it. Testicular cancer is commonly affects men aged 20-44 years old and median age is 33 years old.
Risk Factors
Depends on the causes of scrotal masses, risk factors are different,for example in testicular tortion the most potent risk factor is undescended testicle and genetic structural defects.
Screening
According to the the U.S. Preventive Service Task Force (USPSTF), there is insufficient evidence to recommend routine screening for testicular cancer.