Testicle lump

A testicle lump that does not hurt may be a sign of cancer. Most cases of testicular cancer occur in men ages 15 to 40. It can also occur at older or younger ages.

Possible causes of a painful scrotal mass include:

• A cyst-like lump in the scrotum that contains fluid and dead sperm cells (spermatocele). (This condition sometimes does not cause pain.)
• Epididymitis.
• Infection of the scrotal sac.
• Injury or trauma.
• Mumps.
• Orchitis (testicular infection).
• Testicular torsion.
• Testicular cancer.
• Varicocele.

Possible causes if the scrotal mass is not painful:

• Loop of bowel from a hernia (this may or may not cause pain)
• Hydrocele
• Spermatocele
• Testicular cancer
• Varicocele
• Cyst of epididymis or testicle

Starting in puberty, men at risk for testicular cancer may be taught to do regular exams of their testicles. This includes men with:

• A family history of testicular cancer
• A past tumor of the testicle
• An undescended testicle, even if the testicle on the other side has descended

If you have a lump in your testicle, tell your health care provider right away. A lump on the testicle may be the first sign of testicular cancer. Many men with testicular cancer have been given a wrong diagnosis. Therefore, it is important to go back to your provider if you have a lump that doesn't go away.

Contact your provider right away if you notice any unexplained lumps or any other changes in your testicles.

Your provider will examine you. This may include looking at and feeling (palpating) the testicles and scrotum. You will be asked questions about your health history and symptoms, such as:

• When did you notice the lump?
• Have you had any previous lumps?
• Do you have any pain? Does the lump change in size?
• Exactly where on the testicle is the lump? Is only one testicle involved?
• Have you had any recent injuries or infections? Have you ever had surgery on your testicles or in the area?
• What other symptoms do you have?
• Is there scrotal swelling?
• Do you have abdominal pain or lumps or swelling anywhere else?
• Were you born with both testicles in the scrotum?

Tests and treatments depend on the results of the physical exam. A scrotal ultrasound may be done to find the cause of the swelling.

Lump in the testicle; Scrotal mass

Elder JS. Disorders and anomalies of the scrotal contents. In: Kliegman RM, St. GemeJW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 560.

Fadich A, Giorgianni SJ, Rovito MJ, et al. USPSTF testicular examination nomination-self-examinations and examinations in a clinical setting. Am J Mens Health. 2018;12(5):1510-1516. PMID: 29717912 pubmed.ncbi.nlm.nih.gov/29717912/.

Palmer LS, Palmer JS. Management of abnormalities of the external genitalia in boys. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 44.

Stephenson AJ, Gilligan TD. Neoplasms of the testis. In: Partin AW, Domochowski RR, Kavoussi LR, Peters CA, eds. Campbell-Walsh-Wein Urology. 12th ed. Philadelphia, PA: Elsevier; 2021:chap 76.

Updated by: Kelly L. Stratton, MD, FACS, Associate Professor, Department of Urology, University of Oklahoma Health Sciences Center, Oklahoma City, OK. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.