Testicular Mass vs Epididymitis — SCE Infectious Diseases MCQ
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Correct answer: C — Treat gonorrhoea while continuing the urgent testicular-cancer referral
The best answer is “Treat gonorrhoea while continuing the urgent testicular-cancer referral”. Gonorrhoea causes urethritis and can cause epididymo-orchitis, but a solid intratesticular lesion remains cancer until proven otherwise and needs urgent urological assessment. Current UK gonorrhoea care uses ceftriaxone, appropriate site testing, culture and susceptibility work-up where resistance or failure is possible, and partner management. A solid intratesticular mass requires urgent cancer-pathway assessment and must not be attributed to a concurrent sexually transmitted infection.
Reference: BASHH gonorrhoea guideline 2025: https://www.bashh.org/resources/136/gonorrhoea-2025/ NICE NG12: suspected cancer recognition and referral: https://www.nice.org.uk/guidance/ng12/chapter/Recommendations-organised-by-site-of-cancer