A swollen testicle warrants evaluation

Testicular cancer has a high cure rate when it is diagnosed and treated early. One of its hallmark symptoms is painless testicular swelling.

Doctors from Upstate wrote in the medical journal Cureus about the case of a 24-yearold man who came to Upstate University Hospital because he was coughing up blood.

Imaging scans revealed multiple lesions in his lungs and abdomen that doctors believed to be cancer, but they were not sure in which organ the cancer began. The man mentioned that a few weeks prior, his right testicle had become swollen. He thought it was the result of an intense workout. The swelling resolved on its own, and he thought nothing more of it.

Blood tests indicated testicular cancer.

No tumors were found in the man’s testicles, though, leading doctors to believe he had an aggressive form of testicular cancer. The tumor burned out or disappeared on its own, but not before spreading cancer cells outside of the organ. This happens, rarely. Doctors note fewer than 80 documented cases in the last century.

Two days after the man was admitted to the hospital, he developed a severe headache, and he couldn’t stop vomiting. Medical images of his brain showed multiple spots believed to be cancer.

The man received chemotherapy and radiation therapy. Doctors were considering a stem cell transplant, but the man’s disease progressed rapidly. He suffered severe bleeding in his lungs and died about eight months after his diagnosis.

The doctors involved in the man’s care acknowledge an earlier diagnosis may not have made a difference for him, since the type of cancer he had was so aggressive. The team included oncologists Ajeet Gajra, MD, and Muhammad Naqvi, MD, and fellows Wajihuddin Syed, MD, and Maria Fariduddin, MBBS.

They wrote about this case – with the blessing of the patient’s father – in hopes of reminding young men of the risk of ignoring painless testicular swellings.

“Get timely evaluations even for seemingly trivial testicular swellings so that these tumors are detected early and treated appropriately to improve the odds of cure and survival,” the article’s authors recommend.

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Symptoms requiring attention

These symptoms are more likely to be caused by something other than testicular cancer, including an infection or injury. Still, the American Cancer Society advises men to seek medical attention if they experience: • Painless swelling of the testicle

• A lump in the testicle • Testicular firmness

• Scrotal heaviness

• Aching in the lower belly or scrotum • Enlargement of breast tissue