25 year old caucasion male here. I was wondering if anyone knows what a hypoechoic mass is? A few months ago I found a small lump on my right testicle through a self examination. At first I assumed it was and ingrown hair or something, but I kept an eye on it. Recently I noticed it was bigger and I have had some minor lower abdominal pain (very small) and testicular pain (more like and uncomfortable pulling). I told my dad and he told me that when I was born I had an undecended testicle, even though there is probobaly no relation I decided to get it checked out. I then made an apointment with a urologist. He said the mass was "palapable" and ordered an ultrasound. Apparently there is a "Hypoechoic lesion with blood flow 1.7x2.1cm". The doc told me this over the phone and asked if I plan on having children. I said "of course" (I just got married two months ago afterall). He then said he wants an other ultrasound in three months to see if the mass is growing and told me to take IBprophen. After the phone call I started thinking and I know for a fact that it IS growing because it was smaller three months ago (that's partly why I wanted to get it checked out in the fist place).
Anyway, I'm kinda confused because the doc hasn't given me any idea of what he thinks it could be, and I have no clue what to think. He only told me what I have written. I don't feel comfortable waiting three months to get a clue, but the doc is kind of a jerk and I don't want to agrevate him by bothering him at work to spell things out for me.
Therefor, does anyone have any advice/experience with anything like this situation? I'm not quite sure what I should do, if anything. I'm only trying to be proactive. Or am I over-anaylizing?
I am so sorry that you are having this problem. Did you tell this doctor that you know that the mass is growing? I think you are right to be concerned. If it is something bad 3 months does seem like a long time to wait. It seems as though you don't really like the doctor you went to. I wish that you could go to someone else for a second opinion and hopefully find a doctor you like better. Can you? If it is nothing--fine, but you are concerned enough that I know you want to know for sure and waiting can make a difference if it is something bad.
My 18 year old son was diagnosed with a rare childhood cancer (alveolar rhabdomyosarcoma) on 2/6/04. We had no clues at all -- no mass -- until it had spread throughout his bone marrow and he had anemia.
I asked a friend of mine who had testicular cancer about this and this is what he said:
This reads a lot like my ultrasound -- at least what you posted. That's why I'm responding here. I am not a doctor. I don't play one on TV. I'm just someone who went through a very similar situation. I ended up having stage I seminoma.
Have you had blood work done? Are there elevated markers? If not, it fits the profile of seminoma, though only a biopsy (radical inguinal orchiectomy) will tell for sure.
I did my followup ultrasound 4 weeks later. (3 months sounds excessive to me). In some cases, a month could be excessive. Have you had a chest xray and cat scan yet?
A hypoechoic mass could be an infarction (sometimes they show as hypoechoic areas), but if it does not go away within about a month -- especially if it grows, the chance is very strong that it is testicular cancer.
In my opinion, it should be treated as a suspected case of testicular cancer. Better to err on the side of caution.
I did not have an undecended testicle, but I did have one testicle that was significantly smaller -- as if injured at some point in my childhood, though I have no recollection of such an injury. Trauma or undecended testicle all put someone at higher risk of TC. The smaller testicle developed a tumor.
Regarding the mass, does it feel solid? I used to use the analogy that it kind of felt like the tip of a crayon sticking out -- firmly attached to the testicle.
You are doing the right thing by going to the doctor. If there is one thing I learned, it's "don't be afraid to be pushy in seeking treatment."
Testicular cancer is very treatable and curable. The most crucial part is seeking treatment as soon as it is detected. It might or might not be cancer, but must be treated, at the very least, as a suspected case.
I truly hope and pray that it is nothing, but, as my friend says, "it is better to err on the side of caution," and "don't be afraid to be pushy in seeking treatment."
Your doc doesn't want to bother the urologist, yet doesn't mind you sitting there with a potentially life threatening condition?
First thing i'd do, change doctors pronto and put in a complaint to the general medical council (or your country's equivalent). It's your health that should be the priority not the feelings of some highly strung specialist.
I think some of these people forget that they are here to help the patient (that includes explaining things properly too), and they're well paid for that privilege.
Thanks prayingmom (and your friend!) as well as BJ for the input. I agree, I was thinking along those lines. Its hard to speak of such matters with famliy because I don't want to worry them, especially if there is nothing to worry about, so I thank you. However, prayingmom , your friends description describes my "ahem" excatly. I'm making an appointment with a "real" urologist this morning.
Hypoechoic is a term used to describe a part of an ultrasound image where the echoes (ultrasonic waves) are not as bright as normal or are less bright than the surrounding structures. I would see a second urologist (or even another urologist in this same group if there is one) for another opinion. I would want them both telling me to wait for a three month follow up before I would feel comfortable with that advice.