A 60-year-old man presents with a hard, palpable mass in his right testicle. He denies any pain but admits to recent unintentional weight loss. What are the potential causes, and what are the next steps?
A hard, palpable mass in the testicle is concerning for testicular cancer, particularly in the presence of systemic symptoms such as weight loss. Other less likely causes could include a testicular cyst, hydrocele, or varicocele. The next steps would include an ultrasound of the scrotum to further characterize the mass. If testicular cancer is suspected, additional tests may include blood tests for tumor markers, a CT scan of the abdomen and pelvis to look for any spread of disease, and a referral to a urologist for likely orchiectomy (surgical removal of the testicle).