What is the cause of a 2x2 cm firm, non-tender swelling overlying the superior pole of the left testicle, with no history of injury, in the context of a Comprehensive Medicare (CMS) assessment, where FIRM stands for (Federal Insurance Reform Mandate)?

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Differential Diagnosis for a 2x2 cm Firm, Non-Tender Swelling Overlying the Superior Pole of the Left Testicle

  • Single Most Likely Diagnosis
    • Epididymal Cyst: This is a common, benign condition that can present as a firm, non-tender swelling adjacent to the testicle, often at the superior pole. The absence of injury and the specific location make this a plausible diagnosis.
  • Other Likely Diagnoses
    • Hydrocele: A collection of fluid around a testicle that can cause swelling, which might be firm and non-tender. It's a common condition and could be considered given the description.
    • Spermatocele: A benign cystic accumulation of sperm that arises from the head of the epididymis, which could present similarly to an epididymal cyst.
    • Varicocele: An enlargement of the veins within the scrotum, which can feel like a firm, non-tender swelling, especially when the patient is standing.
  • Do Not Miss Diagnoses
    • Testicular Tumor: Although less likely given the description of the swelling being non-tender and located over the superior pole, testicular cancer can present in various ways, including as a firm, non-tender mass. Missing this diagnosis could have severe consequences.
    • Epididymitis: Inflammation of the epididymis, usually due to infection, which can present with swelling and might initially be non-tender. It's crucial to consider this, especially if there's any possibility of infection.
  • Rare Diagnoses
    • Adenomatoid Tumor: A rare, benign tumor of the epididymis or testicle that could present as a firm swelling.
    • Cystic Dysplasia of the Testis: A rare congenital anomaly that could result in cystic changes within the testicle, potentially feeling like a firm, non-tender swelling.
    • Malignant Mesothelioma of the Tunica Vaginalis: An extremely rare tumor arising from the lining of the tunica vaginalis, which could present with a swelling around the testicle.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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