What are the referral criteria for a patient with a scrotal mass that has changed in size or character over the past month?

Guideline-aligned answer with reasoning, red flags and references. Clinically reviewed by Dr Kola Tytler MBBS CertHE MBA MRCGP.

Posted: 22 August 2025Updated: 22 August 2025 Guideline-Aligned (High Confidence) Clinically Reviewed
Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX

Referral criteria for a patient presenting with a scrotal mass that has changed in size or character over the past month:

  • Consider a suspected cancer pathway referral if the testis is enlarged or there is a change in shape or texture that is non-painful in men, as this may indicate testicular cancer.
  • If testicular symptoms are unexplained or persistent, a direct access ultrasound scan should be considered to further evaluate the mass.

These criteria apply particularly to adult men presenting with such changes and aim to ensure timely investigation and management of possible testicular malignancy.

Therefore, a scrotal mass with recent change in size or character warrants urgent assessment, including referral for suspected cancer pathway or direct ultrasound imaging as appropriate.

References:

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What are the referral criteria for a patient with a scrotal mass that