Triorchidism: a rare case report

Anita R Gune,Rahul P Gune

doi:10.1186/s12301-020-00113-x

Anita R Gune, Rahul P Gune

Open Access

https://doi.org/10.1186/s12301-020-00113-x

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Abstract

BackgroundThe presence of an extra testis is referred to as polyorchidism and is a rare congenital anomaly. There are with less than 200 cases reported, globally. It carries with it, a risk of malignancy making astute diagnosis and follow-up important. The management protocol of polyorchidism is ambiguous with factors such as age of the patient, location, size and anatomical organization of the testicular system playing an important role.Case presentationA 28-year-old male who presented with a non- tender scrotal swelling which on clinical and sonographic examination was diagnosed to be a case of triorchidism (the most common type of polyorchidism). Type 2 polyorchidism with normal epididymis and vas deference was observed. The case was conservatively managed and regular follow-up was advised.ConclusionPolyorchidism is a rare congenital anomaly. Patients with Polyorchidism can be conservatively managed. The reproductive potential and possible concomitant symptoms and complications including cryptorchidism, inguinal hernia and torsion will affect the management strategy. However, if the supernumerary testis is suspected of undergoing neoplastic transformation, it should be resected.

Highlights

The presence of an extra testis is referred to as polyorchidism and is a rare congenital anomaly
If the supernumerary testis is suspected of undergoing neoplastic transformation, it should be resected
The extra testis is commonly present in the Scrotum (66%), inguinal canal (23%) or retroperitoneum (9%) [2]

Summary

Conclusion

Polyorchidism must be considered in the differential diagnosis of solid testicular masses. Ultrasound provides an easy, cost effective tool for diagnosis while MRI allows functional classification. The associated complications such as undescended testes, inguinal hernia, infertility and potential risk of malignancy must be borne in mind. Further management depends on the position of the supernumerary testicle being scrotal or ectopic. The reproductive potential and possible concomitant symptoms and complications must be considered while choosing orchidectomy versus conservation and follow-up. These strategies would appear to be safe to preserve a viable intra scrotal supernumerary testis found incidentally

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