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What is the most likely diagnosis for a painless right-sided scrotal mass that transilluminates?

  1. Hydrocele

  2. Spermatocele

  3. Testicular cancer

  4. Varicocele

The correct answer is: Hydrocele

The most likely diagnosis for a painless right-sided scrotal mass that transilluminates is a hydrocele. A hydrocele is characterized by the accumulation of fluid in the tunica vaginalis surrounding the testicle. This condition is usually painless and can be detected as a smooth, cystic mass in the scrotum. The key feature of a hydrocele is that it transilluminates; when a light is placed behind the mass, the fluid within it allows light to pass through, making the mass appear illuminated. This is an important clinical sign that helps differentiate hydroceles from more solid masses, such as testicular cancer, which do not transilluminate due to their solid nature. While a spermatocele could also present as a painless scrotal mass, it is typically located in the epididymis and is also a cystic structure containing fluid, often transilluminating as well. However, the context of "right-sided" and "most likely" suggests that hydrocele is a more common and straightforward diagnosis. In contrast, testicular cancer typically presents as a solid mass that does not transilluminate and is often accompanied by pain or other systemic symptoms. A varicocele is characterized by enlarged veins within