Ultrasonography with Doppler imaging is done when: The diagnosis is uncertain Usually when hydrocele is present (to diagnose causative scrotal lesions) The mass does not transilluminate If ultrasonography confirms a solid testicular mass, further testing is done for testicular cancer (see Testicular Cancer: Diagnosis), including the following: Beta-human chorionic gonadotropin level (hCG) Alpha-fetoprotein level Lactic dehydrogenase level CT of the abdomen Treatment of Painless Scrotal Mass Treatment is directed at the cause. Not all masses require treatment.