History:
- Duration of symptoms
- Pain
- Associated features of orchitis, risk factors for same
- General medical history including medications
- History of cryptorchidism
- Previous inguinoscrotal surgery
- Personal and family history of cancer (incl testis cancer)
- Social history and future fertility wishes or previous fertility difficulty
Examination:
- General examination / habitus
- Consistency of mass and relation to testis
- Exclude hydrocele or hernia
- Ensure normal contralateral testis
- Lymphadenopathy
- Gynaecomastia / androgenisation
- ?respiratory exam
Investigations
- Urine microscopy and culture
- Bloods – tumour markers (AFP, b-HCG, LDH), FBC/U+E
- Ultrasound
- CT C/A/P – can be done before or after orchidectomy
Differential diagnosis:
