Abstract
Abstract Introduction: polyorchidism is an unusual pathology, about 200 cases in the world literature. Case report: we reported a case of polyorchidism in a 16-year-old male patient diagnosed by ultrasound and confirmed by magnetic resonance imaging. Discussion: most of the cases presented, there is a supernumerary testis, but there are reports on more than three, up to five testicles with supranumerical gonads on both sides of the scrotum. The diagnosis is usually performed in late puberty, incidentally, with a painless scrotal mass or at the emergency room, presenting a testicular torsion of the whole hemiscrotum or supernumerary testisalone, and the differential diagnosis should be made with epididymal cyst and spermatocele, besides other extra-testicular masses (hydroceles, varicoceles, lipomas, tumors.) and para-testicular masses (hernias, scrotal calculi). After the initial clinical evaluation, ultrasound is the first line subsidiary exam. Magnetic Resonance Imaging is very helpful, just in case the ultrasound diagnosis is uncertain. The supernumerary testishave the same Magnetic Resonance Imaging characteristics as the normal testes (intermediate signal intensity on T1- weighted images and high signal intensity on T2-weighted images).
Highlights
Polyorchidism is an unusual pathology, about 200 cases in the world literature.[1]
The diagnosis is usually performed in late puberty, incidentally, with a painless scrotal mass or at the emergency room, presenting a testicular torsion of the whole hemiscrotum or supernumerary testisalone, and the differential diagnosis should be made with epididymal cyst and spermatocele, besides other extra-testicular masses and para-testicular masses
Supernumerary testis diagnosis is usually performed in late puberty, incidentally, with a painless scrotal mass or at the emergency room, presenting a testicular torsion torsion of the whole hemiscrotum or the supernumerary testis alone,[1,2] and the differential diagnosis should be made with epididymal cyst and spermatocele, besides other extra-testicular masses and para-testicular masses.[5]
Summary
Polyorchidism is an unusual pathology, about 200 cases in the world literature.[1] Most of the cases presented, there was a supernumerary testis, but there are reports on more than three, up to five testicles, with supernumerary gonads on both sides of the scrotum.[2,3]. The extra-testis are usually intra-scrotal (up to 75% of the cases), but there are many reports on them presenting as maldescended testis, mimicking an inguinal hernia or even intra-abdominal (up to 5% of the reports).[1,4] The left side is most commonly affected with only as much as 25% of the reports, compromising the right side.[4] Physiopathology for this condition is still poorly understood. The genital crest is conceivable to suffer a duplication, most probably due to incomplete mesonephrondegeneration, which predisposes to the development of peritoneal bands; these bands cause genital crest division.[2]
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