swollen scrotum

Last reviewed 01/2018

A scrotal mass may have a wide range of clinical diagnosis which varies form benign congenital conditions to life-threatening malignancies to acute surgical emergencies (1).

Neoplasia, inflammation or anatomical defects may cause scrotal masses (2).

The cardinal sign of a true scrotal mass is this it is possible to get above it.

A cystic mass can usually be transilluminated. Solid masses do not transilluminate.

An acutely painful scrotum should be treated as a torsion of the testis until proven otherwise.

It is important to differentiate whether the scrotal mass is intratesticular or extratesticular and whether it is cystic or solid (2).

  • intratesticular solid mass - should be regarded as malignant except on rare occasions
  • if extratesticular and cystic - most likely to be benign
  • extratesticular solid masses – almost always benign (with 3% being malignant) (3)