Groin Pain (non-traumatic)

Cancer

Some types of cancer can refer pain to the groin.  Click on each diagnosis to learn more about the signs and symptoms of that type.

Spinal Cord Tumors

Spinal cord tumors are an abnormal growth in or near the spinal cord.  These are most common in young and middle aged adults.  Spinal cord tumors are most commonly found in the thoracic region of the spine.  Spinal cord tumors are similar to intracranial tumors and could metastasize to or from the brain. These tumors also commonly have lymph node involvement.  Pain can refer through the spine, groin, and down the legs.  Pain is usually described as a dull ache, sharp, or knifelike. Pain is also progressively worse over time. 

Hodgkin's Disease

Hodgkin’s disease is a chronic, progressive, neoplastic disorder of lymphatic tissue characterized by painless enlargement of lymph nodes.  It is most common in adolescents and young adults. Males are also more affected than females. Hodgkin’s can progress to the spleen or liver.  It can metastasize to the entire body with the exception of the CNS.  The most common sites are in the groin or neck usually affecting a single side. 

Non-Hodgkin's Lymphoma

Non-Hodgkin’s Lymphoma is a group of lymphomas affecting lymphoid tissue and occurring in a persons of all ages. The most common ages affected are adults between 40 and 60 years of age. Males are also more affected than females.  Those with congenital or acquired immunodefieciencies including HIV are more likely to catch the disease. Exposure to heavy radiation can also increase the likelihood of acquiring the disease. The most common presentation is unilateral groin pain.

Leukemia

Leukemia is a malignant disease of the blood-forming organs. It is most common in children and young adults. One half of all leukemias are acute with a rapid onset and progression of the disease resulting in mortality.  Chronic leukemias are most common in those between the ages of 25 and 60. Leukemia develops in the bone marrow with abnormal multiplication and release of white blood cell precursors. Leukemia is associated with infections and decreased immune system. 

Testicular Cancer

Testicular cancer is a growth in the testicles of males which produce and store sperm and serve as the body’s main source for male’s hormones. It is a rare disease occurring in males between the ages of 20 and 35. Testicular cancer has a great prognosis if detected early.  Testicular cancer presents with a hard, painless lump in the testicle. Monthly self exams for all males are recommended starting at the age of 15. Metastases can occur through blood or lymph system. 

Prostate Cancer

Prostate cancer is a slow growing form of cancer causing microscopic changes in the prostate. Most commonly occurs in males over the age of 50 and occurs in one third of all males. Most common estimated new cases of cancer each year in males.  Males may go years without any symptoms.  It is the second most common cause of cancer and cause of death for males. Prostate cancer is often detected with men presenting with obstructed urine flow and back, hip, or leg pain. Prostate cancer can metastasize through the blood and lymph nodes. 

Special Considerations for Cancer

Signs & Symptoms
  • Bone pain
  • Antalgic gait
  • Local tenderness
Red Flags (click for more red flags)
  • Weight loss
  • Fever
  • Bleeding in the urine
  • Bowel and bladder changes
  • Lump in the groin area
  • Unexplained fatigue
Risk factors
  • Previous cancers
    • Colon can metastasize to the groin
    • Spinal tumor could metastasize to the femur or pelvis causing groin pain
  • Family History
  • Alcohol intake
  • Smoking
  • Inactivity
  • Race
  • Chemical exposure
  • Age

References

  1. Taylor PRA, Angus B, Owen JP, and Proctor SJ.  Hodgkin’s disease: a population-adjusted clinical epidemiology study (PACE) of management at presentation.  Q J Med 1998; 91:131–139. 
  2. Mainiero A, Schnatz PF. Chronic lymphocytic leukemia presenting with localized gynecologic symptoms.  Journal of Lower Genital Tract Disease 2010; 14: 63-64.
  3. Michalowski M, Ketzer C, Daudt L, Rohde LA.  Emotional and behavioral symptoms in children with acute leukemia.  Haematologica 2001; 86:821-826.
  4. Banks PM. Changes in diagnosis of non-Hodgkin's Lymphomas over time.  Cancer Research (suppl) 1992; 52: 5453s-5455s. 
  5. Graham J, Baker M, Macbeth F, Titshall V.  Diagnosis and treatment of prostate cancer: summary of NICE guidance.  BMJ 2008; 336:610-612.
  6. Hsiao CP, Loescher LJ, Moore IMK.  Symptoms and symptom distress in localized prostate cancer.  Cancer Nursing 2007; 30:E19-32.
  7. Soler MD, Kumru H, Vidal J, Pelayo R, Tormos JM, Fregni F, Navarro X, Pascual-Leone A.  Referred sensations and neuropathic pain following spinal cord injury.  Pain 2010; 150:192-198.
  8. Moul JW. Timely diagnosis of testicular cancer.  Urologic Clinics of North America 2007; 34:109–117.
  9. Shaw J. Diagnosis and treatment of testicular cancer. American Family Physician 2008; 77:469-474.

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