Transverse testicular ectopia with inguinal hernia in an adult\u2014a case report

Abstract

BackgroundTransverse testicular ectopia (TTE) is a rare congenital anomaly in which both the testis are in the same hemiscrotum or one testis in the inguinal canal of the same side. It is usually associated with other anomalies such as inguinal hernia, persistent Mullerian duct syndrome (PMDS), true hermaphroditism, and pseudo-hermaphroditism. In this case report, we present a rare case of TTE in an adult patient with fused vas deferens, aplastic right seminal vesicle, and right side inguinal hernia.Case presentationA 33-year-old male came with complaint of severe pain in the scrotum for 2 days with a long-standing history of right inguinoscrotal swelling. Clinical examination revealed a right inguinoscrotal swelling in which right testis was not palpable separately and left testis was palpable at periphery of the left hemiscrotum. Ultrasound imaging and MRI of the scrotum revealed TTE with both testes in the left hemiscrotum, fused vas deferens, right aplastic and left hypoplastic seminal vesicle, right side patent process vaginalis with a non-obstructive, and non-strangulated inguinal hernia. Surgical intervention with transeptal orchidodpexy was advised but not performed due to the patient’s unwillingness. Hence, we recommended an annual follow-up for the same.ConclusionThe present case report emphasizes that though TTE is a rare congenital anomaly, it should be considered as a differential diagnosis in patients with an absent testis and/or infertility, and a detailed imaging and biochemical investigation should be employed considering the wide spectrum of associated conditions.