What are the first tests commonly ordered for evaluating a testicular mass?

The initial evaluation of a testicular mass typically involves imaging and tumor marker assessments, making the combination of ultrasound, beta-HCG, and AFP the optimal first tests.

Ultrasound is the preferred imaging modality for testicular masses due to its ability to provide detailed information about the mass’s characteristic features, such as whether it is solid or cystic, and to differentiate between benign and malignant lesions. It is non-invasive and does not expose the patient to radiation, making it safe and effective for initial assessment.

Beta-human chorionic gonadotropin (beta-HCG) and alpha-fetoprotein (AFP) are key tumor markers that can help in the diagnosis and management of testicular cancers, particularly germ cell tumors. Elevated levels of beta-HCG can indicate the presence of non-seminomatous germ cell tumors, while elevated AFP levels are associated with certain types of testicular cancer as well. Checking these serum markers helps not only in diagnosis but also in treatment planning and monitoring recurrence.

While other tests mentioned in the various options may play roles in different contexts or stages of evaluating testicular masses, they are not as commonly ordered in the initial evaluation as ultrasound and tumor markers. For example, a CT scan might be used later to assess