Lump on epidydimis

[Martin294]

I wonder if anyone has had a similar experience to mine.
About 18 months ago I noticed a small, hard lump in my scrotum which was occasionally uncomfortable - not painful, just an ache.  I eventually had an ultrasound in April 2015 which showed it to be (in a urologist's view) nothing to worry about, although he was unable to say what it was.
I had another scan a few days ago because I thought it had grown, and I also had an occasional ache there.  A different urologist said the same as last time, or similar: we don't know what it is, it's not on the testicle, it's on the epidydimis, it's now 13mm long compared to 9mm 13 months ago, epidydimal cancer is very rare but we can only rule it out if we remove it.
He seemed quite relaxed and said he wouldn't expect as little growth in 13 months if it was cancerous.  When I said I'd like it removed he talked about a 6-8 week wait on the NHS, so I was reassured by the apparent lack of urgency.  But I'm going to ask to go privately as soon as possible as I think my insurance will cover it.  In fact, if it doesn't I'll just pay the £1000 or so rather than wait and worry.
I told him I wish he was able to list possible causes other than cancer.  They all seem to involve soft lumps and this is hard.  He mentioned a couple of vague possibilities but I'm probably wrong to read too much into his words or lack of them.  So I'd love to know if anyone out there has had a hard lump on the epidydimis...

[Martin294]

Thanks Mike.  I saw a second (highly-rated) urologist 2 weeks ago who immediately said it wasn't malignant, it was a granuloma - apparently these are common post-vasectomy (which I haven't had) but can also occur without a vasectomy.  He said removal of the epidydimis would be a 'cosmetic' operation and tried to dissuade me from this, quoting the possible complications.  I see him again in 3 months and he'll check the scans in the meantime.

In his subsequent letter to the GP he backtracked somewhat, in that he cannot categorically rule out cancer without (as you say) removing the mass and analysing it, but said that as the risk is 'very low' he advises 'conservative' treatment.  I was impressed by his confidence in his ability to advise against potentially life-saving surgery, but I'm sure he wouldn't so advise lightly and therefore bow to his knowledge and experience.

An important factor seems to be the level of discomfort I get - the relevance here seems to be 'Can I tolerate it?' rather than 'Pain = seriousness' and lately I've been more comfortable.  So I think I'll leave it for now but if the discomfort flares up I may pursue an operation.

[MikeCraycraft]

Epidydimal malignancies are somewhat rare and I am not very knowledgable about them. Did either doctor mention doing any repeat ultrasounds and if there are certain characteristics that they may look for to give a better indication if it would be a malignancy or not? For example, is there a certain size breakpoint or presence or absence of doppler flow that may better help predict if it is malignant or benign? Certainly going private and getting another evaluation is reasonable as the only way to really be certain is to remove it and have it looked at by pathology but one doesn't want to remove a testicle if it isn't necessary.