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9 year old with a hydrocele and a lump

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  • 9 year old with a hydrocele and a lump

    Hi all

    ​So we decided to spend an extra day on holiday the week before last and are so glad we did. It meant our child got to play with his younger cousins on the water slide. They all decided after a while to strip off and go naked. During this we noticed our son had a very large right testicle (like 5 times bigger!) the next day after arriving home we took him to the GP who said the swelling was likely a cyst. That Friday we took him in for an ultrasound, he was such a champ! We had no idea he had this swelling and he said it had been like if for years. Anyway, within 2 hours after the ultrasound our GP called. He said that the swelling was a hydrocele but they also found a lump on his 'good' left testicle, which he was very concerned about. I did see this during the ultrasound as a largish black oval area in/on his other testicle and thought it must have been something as multiple pictures were taken. He said he was making an urgent referral to a urologist to rule out cancer.... he said that word and I don't think I heard a lot after this. Within 30min I then got a phone call from the Urologist place saying they had no ped urologists on for this coming week but she had given his case to another doctor to look at over the weekend and they would all be discussing his case this week at their big meeting.

    ​We don't know for sure that it is cancer but I've done the worst thing possible and googled everything trying to find something else that it could be. There is practically nothing about paediatrics and the chances are so low....... I don't know if the hydrocele on one is related to the lump on the other. So many questions but now we wait. Friday was scary with everything happening so quickly and now it's Sunday and we cant do anything but wait.

    ​Our child is happy as! He is full of life, just like any other child. We haven't told him anything (or his older brother). But if what I've read is correct they generally remove that testicle (cancerous or not). How do you tell your 9 year old child hes going to lose a testicle? I'm guessing they will remove the hydrocele in the other testicle while they're at it. I'm trying to not get too far ahead of myself but I am his mum and I am scared.

    ​Has anyone else come across both testicles with something wrong or have a young child dealing with this?
    Thanks for taking the time to read.

  • #2
    Hi Mitchell and mom,

    Sorry, you are going through this.

    I experienced my TC at 31 but I suspect the same applies to pediatric cases: a hypoechoic mass on or inside the testicle itself is treated like cancer until proven otherwise. TC is known as "young man's disease."

    As FYI: one of the predisposing factors for TC is undescended testicle. Has this been the case for the "good one" perhaps?

    Losing the testicle isn't a big deal in the long run. You should talk about a prosthetic --maybe he wants one; I would imagine if I were a teen I'd want to be as anatomically normal as possible if I can. Not sure if the size would need to change based on age.

    Having one testicle doesn't affect sexual function in any way. It may result in hypogonadism (low testosterone) in some cases (like mine). This is treatable though.

    Has your urologist done any lab orders for tumor markers (AFP, hCG, and LDH)? This is usually done when they schedule orchiectomy alongside with imaging (CT scan of abdomen and pelvis).

    If you share with us your location, perhaps folks on the forum can suggest docs/resources.

    Keep up your spirits! Even if it is TC, it is almost certainly curable except in very advanced cases. In early stages, the cure rate approaches 100%.
    Last edited by mcintoda; 01-13-19, 03:38 PM. Reason: Removed: Regarding the hydrocele and the comment that "it's been enlarged for years." This is unlikely to be cancer at this point as cancer doubles every month or so.
    Age 31 - Portland, OR
    01NOV16- Pain in right testicle, palpable mass
    13NOV16- R I/O. Markers normal
    27NOV16- Stage Ia non-seminoma, 1.3cm, 100% EC, no LVI
    06DEC16 - CT scan clear
    09DEC16 - Started 1xBEP. Neutropenic at day 15; Worst part for me was bleo (allergic).
    03JAN17- Ended 1xBEP; start surveillance
    18MAR17-2nd pathology report shows 90% EC , 10% seminoma


    • #3

      ​Thanks for your response! Yeh, our GP isn't too worried about the one with the hydrocele which I guess is something. No, no undescended testicles... he was born with multicystic dysplastic kidney and had his right kidney removed when he was 2. Don't think that's relevant though? We haven't seen the urologist yet hence I may be getting a bit ahead of myself? but from the phone call I had from their lovely receptionist on Friday they are onto it and taking it very seriously (lots of urologists will be looking at his case this week at their meeting and coming up with a plan) so will get an appointment very soon.
      ​We are in NZ.

      ​If it all happens will certainly talk to him about prosthetics! thanks for that! that I think would be a big thing for him - being the same as other boys his age. He is very self conscious.
      ​Thanks again for your response, so pleased I found this site!


      • #4
        So sorry! Did they at least draw tumor markers while making you wait for a Pedi urologist? I assume you are not in the US? My son was a teenager, but initially misdiagnosed. His testicle was supposedly as big as a tennis ball! Please know that pre-puberty TC is treated a little differently than post puberty. If it turns out to be TC, please let us know.
        Son Grant
        dx 12/21/16 at age 17

        BEP x3
        Post Chemo CT Scan on 3/28/17 still showed a few nodes over 2 cm
        2nd Post Chemo CT Scan on 4/27/17 showed all nodes still over 2cm
        Post Chemo RPLND 5/8/17: Periaortic Teratoma, Intraaorticaval Teratoma, and Paracaval Teratoma found.


        • #5
          Hi Trekga - no bloods taken yet. I'm tempted to go back to the GP on Monday and ask some more questions but don't know how much more he can tell us. A tennis ball! far out that would have been scary for you all!


          • #6
            Originally posted by mcintoda View Post
            Sorry, you are going through this. Regarding the hydrocele and the comment that "it's been enlarged for years." This is unlikely to be cancer at this point as cancer doubles every month or so.
            Sorry, but that is not accurate in every case. I was aware I had TC for a year before getting it checked out the second time. It got very unusually shaped, but did not grow any larger. Please lets be sure we are giving accurate info on this forum, someone's life might depend on what is said.

            Micthchell's Mom: At 9 years old, unless he has experienced early puberty, its unlikely, but not impossible to be TC. I cannot recall any cases pre-puberty on this forum, but not saying it hasn't happened.
            Not sure about a prosthetic at his age, how to size it? Normal at 9 is going to be way to small at 12 or 13. I guess normal adult would work best long term,but difficult decision, he's probably not aware enough to make the decision at 9 years, so probably your call & unless he's already had "the talk" you might not want to bring it up beyond 'it will feel a bit different after the surgery"

            Nobody is every ready for a TC Dx, but a 9 year old has no concept of cancer, so I cannot even imagine the difficulty you are going through. I would, however get a hold of Doc E & get his opinion before proceeding.At his age this is an *very* unusual case, if it is TC at all.I will be surprised if it is.

            Jan, 1975: Right I/O, followed by RPLND
            Dec, 2009: Left I/O, followed by 3xBEP


            • #7
              Good news so far! Went back to GP to ask more questions and get bloods done. He did the tumor markers, blood cells, testing for kidney and liver function (he is missing a kidney). He said it is a solid mass not cystic...anyway.. he called today and the bloods have come back normal! Tomorrow we will hear from urologist place. I've no idea what it could be or what the next step is but am pleased bloods are good (he did say its not infallible but still taking it as promising).


              • #8
                Yes, normal bloodwork is always positive, but it does not rule out TC since not every TC produces markers. waiting for answers is often the hardest part of this journey.

                Jan, 1975: Right I/O, followed by RPLND
                Dec, 2009: Left I/O, followed by 3xBEP