Testicular cancer (assumed)
Referred to investigate a lump in the right epididymis. The patient also complained for right testicular discomfort. He had previously been affected by right-sided epididymo-orchitis but the current pain was not to this level.
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An intratesticular mass was seen within the lower pole of the right testis. It had irregular margins, which appeared to cross and disrupt the tunica albuginea. At this site, the testis felt hard but elsewhere felt soft and pliable. The left testis also felt soft and pliable.
The arterial blood flow within the mass was biphasic, which is not in keeping with focal orchitis. The intratesticular flow elsewhere within the right testis was normal, low-resistance, continuous forward flow.
The patient has been booked in for an orchectomy.