Testicular cancer is one of the most common solid malignancies among men aged 15-35 years and is associated with excellent outcomes when identified early. Ultrasound is the first-line imaging modality for evaluation of scrotal pathology; however, access to timely imaging may be limited in low-resource primary care settings. This case describes a young male who initially presented with asymptomatic microscopic hematuria and later disclosed unilateral scrotal swelling. Initial urologic evaluation and computed tomography (CT) imaging failed to identify testicular pathology. Subsequent point-of-care scrotal ultrasound performed in a primary care clinic revealed a large complex cystic mass, prompting immediate escalation of care. Further evaluation confirmed a primary testicular malignancy, and the patient underwent definitive surgical management with radical orchiectomy. This case highlights the critical role of point-of-care ultrasound in facilitating early recognition and timely referral for testicular malignancy in low-resource settings. Primary care physicians should remain vigilant for atypical presentations and be proficient in identifying concerning sonographic features to reduce delays in diagnosis and intervention, thereby improving patient outcomes.
Noble et al. (Tue,) studied this question.