This page was reviewed under our medical and editorial policy by
Maurie Markman, MD, President, Medicine & Science.
This page was updated on June 8, 2022.
It’s important for men to pay attention to their reproductive health, which includes regular self-examinations to check for any changes, especially in the testicular and scrotal area. If a scrotal mass or lump is found during a self-examination, it's important to keep in mind that most testicular lumps are not cancerous.
On average, one of every 250 males will develop testicular cancer over their lifetime, according to the American Cancer Society (ACS).
The testicles are an important part of the reproductive system, playing a key role in producing testosterone and sperm. When feeling the scrotum (the skin pouch that holds the testicles), a healthy testicle should feel smooth, without any irregularities. However, sometimes testicular lumps may develop. A testicular lump may feel hard or soft to the touch and vary in size. It also may feel painful, tender or swollen, but some lumps may be completely painless.
Some doctors recommend performing monthly self-exams to check for changes. Men who are planning to do this should speak with a doctor first to make sure this screening is right for them.
Men may do a self-examination either in the shower or right after, when the skin is soft. To self-examine:
The different types of testicular lumps are categorized based on whether they’re benign (noncancerous), precancerous or cancerous.
Benign testicular lumps aren’t caused by cancer, and they aren't likely to develop into cancer in the future. Common benign testicular lumps include those listed below.
Benign teratoma: This type of germ cell tumor occurs most often before puberty, usually in babies. It may be removed by surgery.
Lipoma: Because this tumor is made of fat cells, it may occur anywhere on the body, and sometimes develops in the testicles. A lipoma also may be surgically removed.
Epididymitis: The epididymis is a coiled tube at the back of the testes that the body uses for storing and transporting sperm. Sometimes, it becomes inflamed, causing swollen or sore testicles. It may be treated with antibiotics.
Epididymal cyst: This is a fluid-filled cyst that develops in the epididymis and may be surgically removed, if deemed necessary
Orchitis: This is a bacterial or viral infection in the testicle. It may cause pain and swelling, which may be mistaken for a lump. It may be treated with medication.
Hydrocele: This fluid-filled sac occurs around a testicle and is generally painless. If it doesn’t disappear on its own or becomes too large, a hydrocele may require surgery.
Varicocele: This is an enlargement of the veins inside a testicle. Treatment isn’t always needed, but it may be surgically removed if it continues to grow or causes pain.
Other, much rarer testicular lumps include gonadal stromal tumors, which make up less than 5 percent of adult testicular tumors, according to the ACS. They are typically benign and don’t spread.
Sometimes, a testicular lump is precancerous, which means it isn’t cancer but may develop into cancer in the future.
One of the most common precancerous lumps is known as germ cell neoplasia in situ. This type of abnormal cell growth is considered a precursor to testicular cancer. Germ cells are cells in the testicles that make sperm, and neoplasia is a type of abnormal cell growth.
It may be diagnosed through a biopsy. If the medical team finds germ cell neoplasia in situ, they may discuss treatment options with the patient.
A testicular cancer diagnosis is made through procedures including imaging tests, blood tests for tumor markers, and a type of surgery known as a radical inguinal orchiectomy (in which the testicle is removed and a biopsy is performed to detect cancer).
If a lump is malignant, it's reassuring to know that testicular cancer has a very high survival rate, especially if it's diagnosed early.
More than 90 percent of cancerous lumps of the testicle originate in the germ cells, according to the ACS.
Germ cell tumors are broken down into two types, as follows.
Seminomas: This type of tumor tends to be slow-growing, compared with non-seminomas. Seminomas are either classical or spermatocytic. According to the ACS, more than 95 percent are classical, while slower-growing spermatocytic tumors tend to be rare and occur in older men (average age is 65).
Non-seminomas: These tend to develop in the late teens to early 30s. Non-seminomas may be categorized as one of the following: embryonal carcinoma, yolk sac carcinoma, choriocarcinoma and teratoma.
However, germ cell cancers may be a mix of these two types of cells. They usually respond to treatments for non-seminoma cancers.
Cancer that starts elsewhere in the body and spreads to the testicles is considered secondary testicular cancer.
If a man feels a lump in his testicle, or is concerned about a change in its shape or size, he should discuss this with a doctor.
Don’t panic: Men may feel nervous, scared or worried. These feelings are completely normal, but it’s best to remain calm. Most testicular lumps are benign.
Often, testicular lumps are caused by something other than testicular cancer. Sometimes, an infection may cause swelling and tenderness.
Visiting a doctor as soon as possible is the best thing to do. Lumps may be easier to treat if they’re caught early, while they’re still small.
Ask questions: It’s okay to ask questions. The doctor may ask the patient some as well, including how long he's had the testicular lump, whether it’s changed over time, and whether he has other symptoms. The doctor may also ask about personal and family medical history to assess the patient's risk factors for testicular cancer.
A doctor won't be able to tell whether a testicular lump is cancerous or if it's a cyst just by feeling it. Instead, they will perform a series of tests and exams as part of the diagnostic process.
To learn more about the causes of a testicular lump, the doctor may recommend several tests. Some of the diagnostic tests used for testicular cancer include those listed below.
Physical exam: The doctor will check the patient's overall health and examine his testicles for signs of disease.
Ultrasound exam: A doctor may request an ultrasound examination, which uses high-energy sound waves to create sonogram images of the inside of the testicles.
Serum tumor marker test: Another common diagnostic tool, this is a blood test that looks for substances in the body that are linked to testicular cancer, known as tumor markers. In the case of testicular cancer, doctors are looking specifically for two markers: alpha-fetoprotein and beta-human chorionic gonadotropin.
Inguinal orchiectomy: In this procedure, the entire testicle may be removed from an incision in the groin area. Tissue cells from the testicle are then examined under a microscope for cancer cells. This method is safer than a biopsy, because removing the tissue sample during a biopsy may, in rare cases, accidentally spread cancer into the lymph nodes or scrotum.