Question

History of Present Illness

A 17 y.o. male presents saying, “I have a lump in my testicle!” He noticed a mass while showering the previous night, and his mother called to have him seen today. He denies any associated pain but says it feels as if he has “grown a third testicle.” He has heard that teens are at heightened risk for testicular cancer and seems concerned for that. He is athletic and is in the midst of the soccer season but does not recall an injury in play or practice nor in other activities. He says he does not know how long it has been present, although he thinks he would have felt it by now if it had been this large for long.

Past Medical/Surgical History

• Asthma, uses a long-acting beta agonist and corticosteroid combination inhaler; does well on this regimen, not experiencing increased symptoms
• Mild acne
• No surgeries

Review of Symptoms

• Not obtained yet

Current Meds

• Long-acting beta agonist and corticosteroid inhaler
• Topical benzoyl peroxide

Physical Examination

• Vital signs: T 98, BP 98/68, HR 64, HT 70, WT 150 lbs.
• General: Slender, well-developed young male who appears slightly anxious as he describes his complaint but otherwise in no distress.
• Genitalia: Exam of his scrotum-skin is moderate pink, dry, and intact. Noticeable area of enlargement on the left. Right testicle is freely mobile, smooth, and rubbery; ovoid in shape and epididymis is palpable. On the left, testicle is isolated from the mass and is mobile with consistency similar to the right, although there is a mass just proximal to the testicle that is approximately 3 cm in diameter, well-defined with smooth surface and cystic (nonsolid) consistency. Mild discomfort voiced with the exam. No visible lesions identified. No palpable inguinal nodes.

Answer 1

Testicular cancer forms one of the devastating disease of new generation ageing between age 15 to 35 years in US.

According to the physical examination it reveals that the cyst is painless nor having any discharge and other symptoms typical to testicular cancer.Spermatic  cyst or Epididymal cyst or spermatocele.

It is usually a painless,non cancerous (benign) fluid filled containing sperm. This happens when the sperms cannot be drained out resulting in the lump.It is a very common condition and resolves on its own.The treatment suggested for this is usually incision and drainage.Followed by proper wound care ,personal hygiene and regular monthly self examination. A counselling will be needed for the client to relieve his anxiety level.He can resume his game after complete recovery to prevent further or unexpected events.