Polyorchidism Research Articles

The Sonographic Appearance of Polyorchidism: A Multiple Case Report

The traditional sonographic characteristic used to distinguish polyorchidism (PO) has been its homogeneous echotexture, which is similar or identical to the normal testicle. PO is most commonly found in the left hemi-scrotum but can also be identified in the right hemi-scrotum, inguinal canal, or abdominal cavity. The mediastinum of a testicle represents where the tunica vaginalis and tunica albuginea that encases a testicle folded back in on itself. The identification of a mediastinum in a scrotal lesion implies that testicular tissue is present. This series review presents three cases where PO was identified in the left hemi-scrotum. In addition to the classic homogeneous echotexture that is typically identified in an accessory testicle, a mediastinum was also appreciated in two of the cases, which helped to solidify the diagnosis of polyorchidism.

POLYORCHIDISM

Polyorchidism is a very rare anomaly that is defined by the presence ofmore than two testes. Knowledge about the condition and accurate imaging diagnosis andcharacterization is important to decide the optimal line of management and avoid unnecessarysurgery. A 14-year-old male reported for Scrotal Color Doppler Ultrasound with complaint ofa painless mass in the left scrotum with no history of trauma. On physical examination, therewere two palpable, ovoid, mobile, non-tender masses in the left hemiscrotum. Scrotal ColorDoppler Ultrasonography (USG) revealed a well circumscribed supernumerary testicle in theleft scrotum adjacent to superior pole of left testis with parenchymal echogenicity and dopplervascularity like that of normal testis parenchyma. In conclusion, diagnosis was polyorchidismwith duplication of the left testicle. The patient was advised follow-up after one-year. USG is themodality of choice to assist in the diagnosis.

Quadriorchidism: A case of bilateral supernumerary testicle and review of the literature

Polyorchidism, which means one or more additional testicles, is a congenital anomaly and is seldom observed. In many polyorchidism patients, there is one supernumerary testicle (SNT) (triorchidism) whose left face is often the presentation. Two-sided SNT is very rare, and has been reported only in six cases. Here, we are presenting a male case who was six years old with bilaterally SNT (quadriorchidism) in scrotum that presented as asymptomatic masses.

Polyorchidism a rare cause of scrotal masses in the child a case report

Scrotal masse due to polyorchidism is not frequent in children. We report 1 case of polyorchidism associated an hydrocele in an eight years old boy. The diagnostic of the scrotal masses was done by physical examination. Cure of hydrocele was done with a conservative management of the polyorchidisme based on clinical and sonography surveillance of supernumerary testicle.

Polyorchidism. Atypical Presentations of Supernumerary Testicle Can Lead to Misdiagnosis

Polyorchidism. Atypical Presentations of Supernumerary Testicle Can Lead to Misdiagnosis

A case of cyclist’s nodule in a female patient

There are few reported cases of cyclist’s nodule in females. The condition has thus lent itself to synonyms such as third, supernumerary or accessory testicle. We report the imaging findings of a perineal nodule in a 29-year-old female patient who is a known cyclist, and discuss the differential diagnosis.

A case of cyclist’s nodule in a female patient

There are few reported cases of cyclist’s nodule in females. The condition has thus lent itself to synonyms such as third, supernumerary or accessory testicle. We report the imaging findings of a perineal nodule in a 29-year-old female patient who is a known cyclist, and discuss the differential diagnosis.

A rare presentation: duplication of testis

Objective of current study was to describe the clinical and embryological futures of polyorchidism and review of literature of similar cases. Polyorchidism is usually an incidental finding and an extremely rare congenital anomaly with less than 200 cases reported so far. Several theories regarding it but the exact explanations are still unknown. In majority of cases, patients are asymptomatic and have a painless inguinal or scrotal mass. While others may present with maldescended or cryptorchidism or incidentally discovered in association with indirect inguinal hernia, hydrocele, varicocele, epididymitis, infertility, testicular torsion, and extremely rare with testicular malignancy. Among polyorchidism, majority of cases are of triorchidism usually of left side. In present case report, triorchidism in its rarest form is diagnosed incidentally intraoperatively in an adolescent presented with left groin swelling and ipsilateral undescended testicle. The supernumerary testicle was intraoperatively found in peritoneal cavity and completely developed with separate cord structure and epididymis.

Polyorchidism: A Meta-Analysis

Polyorchidism is an uncommon congenital anomaly. We systematically analyzed the literature due to the contradictory data regarding this condition. We conducted a database search and evaluated relevant articles for the appearance, comorbidities and complications of supernumerary testes. Only cases of polyorchidism confirmed by histological examination were included in the study. We found 140 cases of polyorchidism. Triorchidism was the most common type, and 6 cases of 4 testes (4.3%) were reported. Most supernumerary testes (64%, chi-square p <0.001) were drained by a vas deferens. Median patient age at detection was 17 years. Left side demonstrated predominance (64.5%, chi-square p <0.001). Most cases were found during surgery for other symptoms including inguinal hernia, undescended testicle, testicular torsion and scrotal pain. Only 16% of patients complained of an accessory mass without any symptoms. Neoplasms were found in 9 cases (6.4%), of which 8 were malignant and 1 was benign. Data available for 7 malignomas (88%) revealed that all were in cryptorchid supernumerary testes. Polyorchidism is rare and is generally found during evaluation for other conditions such as inguinal hernia, undescended testis and testicular torsion. Cryptorchidism appears to be the most important risk factor for malignancy in patients with supernumerary testes. Thus, patients with nonscrotal supernumerary testes require appropriate counseling. The supernumerary testis is frequently drained by a vas deferens, implying a probable reproductive function. Decision for surgery, biopsy or orchiectomy should be based on concomitant symptoms, cryptorchidism or suspected malignancy. We provide a guideline for management based on a functional classification of polyorchidism.

Perineal nodular swelling in a recreational cyclist: diagnosis and discussion

DiagnosisThe diagnosis of a biker’s nodule was made, based merelyon the clinical history, the typical location and the imagingfindings.DiscussionAbiker’s nodule is a lesser known condition of the perineumthataffectscyclists.Thelesionhasbeenpreviouslyknownbymany synonyms, including ‘third or supernumerary testicle’,‘accessorytesticle’,‘perinealhygromaorinduration’[1–5]. Itis typically located in the paramedian region of the perineum,posterior to the scrotal sac, and is covered with normal skin.The size of the lesion rarely exceeds 3 cm [1–5].Symptoms include pain on pressure and when sitting onthe saddle, which often forces the athlete to give up ridingthe bicycle. On palpation, the nodule is solid andsometimes adherent to the adjacent soft tissue [2, 5]. Thelesion is believed to result from increased pressure,vibration and friction between the ischial tuberosities andthe hard saddle, characteristic of racing cycles or mountainbikes, with constant rubbing of the superficial perinealfascia against the bony structures [1–5].Histopathology shows a myxoid degeneration of thefatty tissue and collagen fibers overlying the ischialtuberosities, caused by necrosis of the superficial perinealfascia, sometimes with formation of pseudocysts [1–5]. Thelesion is not well vascularized [2].Imaging characteristics are only rarely reported. Ultra-sound shows a hypo-echoic nodule, with absence of anyincreased power Doppler signal [1]). Small internal cysticareas may be seen as well [1]. On computed tomography(CT), the lesion shows no uptake of contrast agent [3], whichis explained by the hypovascular nature on histology. To ourknowledge, magnetic resonance imaging (MRI) has not beenreported. As in CT, there is no uptake of contrast medium.The primary role of imaging is to determine the exact extentof the lesion. Ultrasound and MRI are particularly helpful inlocating the lesion in the subcutaneous fatty tissue and closeto the ischial tuberosities. In most clinical scenarios,ultrasound will suffice for imaging evaluation. Imaging hasan additional role in the differentiation between ‘biker’snodule’ and other causes of a perineal swelling. Thedifferential diagnosis [1, 3, 5] includes abscess, epidermalcyst, (cutaneous) adnexial mass, lipoma, and malignanttumor (soft tissue sarcoma or metastasis).In biker’s nodules, signs of inflammation or abscessformation are lacking, and the absence of contrast agentenhancement on MRI excludes malignancy.The primarytherapy consistsofavoidance ofthe causativefactor. Rest alone is generally not sufficient as therapy. Thecondition almost systematically imposes saddle adjustments

Poliorquidismo

To report one case of supernumerary testicle, a rare entity with around 100 cases published. 44-year-old male patient consulting for incidental discovering of a right scrotal mass. The diagnosis of polyorchidism was suspected after physical examination, ultrasound, and CT scan, and confirmed subsequently on surgical exploration and biopsy. Due to the absence of pathology and complete normal seminal lines decision was taken to not perform orchiectomy of the supernumerary testicle. There are classifications for proper evaluation of polyorchidism, which state the relation between site of the testicle in relation to scrotum, existence or absence of independent epididymis and vasa deferentia for both testicles. Although remotely, there is a possibility of malignant degeneration of these testicles, so that surgical exploration and excision of the supernumerary testicles when their biopsy is doubtful in terms of dysplasia or if they present carcinoma in situ or they are a source of pain.

Un cas rare de polyorchidie : revue de la littérature

Polyorchidism is a rare congenital anomaly. We report 1 case in a Malagasy young man revealed by left scrotal mass. The diagnostic was suspected by clinical examination and confirmed by testicular sonography. Management is conservative, based on clinical and sonography surveillance of supernumerary testicle.

Polyorchidism; a report of two cases with torsion.

Polyorchidism; a report of two cases with torsion.

Supernumerary Testicle in a Case of Polyorchidism

Introduction: The presence of more than 2 testicles is called polyorchidism. It is a rare anomaly. Less than 100 cases have been reported in the literature. Clinical Picture: A 51-year-old man complained of a painless right groin lump for a year. Physical examination revealed a discrete ovoid non-tender, firm but mobile lump. No cough impulse was demonstrated. Sonography demonstrated a soft tissue structure within the tunica vaginalis inferior to the deep inguinal ring. It demonstrated similar echotexture and vascular flow as the normal testis, but smaller in size. The findings were compatible with a diagnosis of polyorchidism. Treatment: The patient was not keen for surgery and was followed up conservatively. Conclusion: Differential diagnosis of a solid extratesticular mass should include polyorchidism.

Polyorchidism: imaging may denote reproductive potential of accessory testicle

MRI in a 9-year-old boy with left testicular polyorchidism and prior right orchiectomy showed single epididymis-ductus deferens complex. This anatomical arrangement suggests the possibility of reproductive potential and alters the patient's management.

Triorchidism in the sibling of a patient with recently diagnosed seminoma

Triorchidism in the sibling of a patient with recently diagnosed seminoma

Case of Polyorchidism

Case of Polyorchidism