• Enlargement of a testicle or a change in the way it feels
• Lump or swelling in either testicle
• Dull ache in the back or lower abdomen
• Gynecomastia (excessive development of male breast tissue), this can also occur normally in adolescent males, in whom it is not a symptom of testicular cancer
• Testicular discomfort/pain or a feeling of heaviness in the scrotum
• Occasionally, the initial symptoms are related to the spread of the cancer to other parts of the body, such as the lungs, abdomen, pelvis, or brain

Note: There may be no symptoms.

• Scrotal ultrasound is used to confirm solid mass.
• Blood tests for tumor markers: alpha-fetoprotein (AFP), human chorionic gonadotrophin (beta HCG), and lactic dehydrogenase (LDH). Approximately 85% of non-seminomas will have elevations of either AFP or beta HCG. Seminomas will have elevations only in beta HCG or LDH. These tests can also be used to monitor the response to treatment.
• A chest X-ray is done to look for potential metastasis (spreading of cancer) to the lungs.
• An abdominal CT scan may be done to look for potential metastasis.

Tissue biopsy is usually by surgical removal of the testicle. After the testicle is removed, the tissue is examined.