Histologic combinations are common, eg, teratocarcinoma contains teratoma plus embryonal carcinoma. Functional interstitial cell carcinomas of the testis are rare. Tumors arising in the epididymis, testicular appendages, and spermatic cord usually are benign fibromas, fibroadenomas, adenomatoid tumors, and lipomas. Sarcomas, most commonly rhabdomyosarcoma, occur occasionally, mostly in children. The usual presenting sign is a scrotal mass, sometimes associated with pain.
Many patients discover the mass in association with minor trauma.
Hemorrhage into the tumor may produce local pain and tenderness. Any firm mass in the testis is cause for immediate clinical suspicion of testicular tumor. Physical examination and US may localize the lesion to the testis. The diagnosis is established by inguinal exploration, exposing and clamping the spermatic cord before manipulating and exposing the abnormal testis. Pedal lymphangiography is rarely performed.