QuestionSBA
QuestionChoice
Although it is very important to address the patient's concerns, a diagnosis of a cancer is very unlikely. There is no discrete lump firstly, but there are also features of varicocele which is more common.
10027958
c
Testicular tumour
QuestionChoice
The enlarged veins and aching pain at the end of the day indicates a diagnosis of varicocele. Typically, the enlarged veins may be described as a "bag of worms".
10027956
a
Varicocele
QuestionChoice
Epididymo-orchitis is an infection of the epididymis and testes. It can cause pain and swelling. However, the pain is usually severe and sudden onset which is not the description of pain in the case above. As this is an infection, the patient may also have a fever and other signs of infection such as urethral discharge.
10027960
e
Epididymo-orchitis
QuestionChoice
Hydrocoele is the accumulation of fluid within the tunica vaginalis. This presents with a swelling in the scrotum, but this is normally painless rather than the aching pain that is described in this case.
10027957
b
Hydrocoele
QuestionChoice
Testicular torsion is a urological emergency so is very important to rule it out. Typically, the pain in testicular torsion is very severe and sudden onset. There may also be nausea and vomiting. In this case, there are no features of being acutely unwell so we can rule out testicular torsion.
10027959
d
Testicular torsion
Concept
Chapter
2693
4423
Varicocele
Topic
179
Vascular Surgery
17989
A 23-year-old man presents with a swelling and aching feeling in his testicles. It is worst at the end of the day when he feels "heavy". He is concerned about the swelling and thinks he may have a testicular tumour. On examination, there are visibly enlarged veins in the scrotum.

What is the most likely diagnosis?
a