Torsion of bilobed testis and biopsy-proven ipsilateral supernumerary testis in an adolescent

Polyorchidism: An Up-to-Date Systematic Review

Polyorchidism is a rare male urogenital tract anomaly characterized by at least one supernumerary testis in the scrotum or ectopically. According to data based on our systematic review, 76% of the supernumerary testes (SNTs) were located in the scrotum, and 24% were extra-scrotal (p < 0.001). Among testes located outside the scrotum, 87% were found in the inguinal canal and 13% in the abdominal cavity. In 80% of cases, the diagnosis of SNT was made based on imaging tests, and the remaining 20% of cases were detected incidentally during surgery. The imaging tests performed (US or MRI) resulted in a significantly higher rate of patients who qualified for observation vs. surgical treatment (45% vs. 35%, p < 0.001). The most common conditions associated with SNT were ipsilateral inguinal hernia (15% of cases) and cryptorchidism (15% of cases). Surgery (orchidopexy/orchidectomy) was performed on 54% of patients with SNT, and the decision to observe the SNT was made in a total of 46% of patients (p = 0.001). The therapeutic approach depends on the location of the SNT and the presence of factors that raise suspicion of neoplastic proliferation.

Bilobed testicle diagnosed by ultrasound in a 9-year-old boy

Bilobed testis is an extremely rare congenital malformation, and even rarer on the right side. Only 7 cases have been reported in the literature. We describe the case of a 9-year-old boy with a right bilobed testicle confirmed on ultrasound and discovered incidentally as a mass on physical examination. The aim of our work is to consider the bilobed testicle as a differential diagnosis of a testicular mass despite its rarity and to show the importance of ultrasound and MRI for its definitive diagnosis to avoid unnecessary surgery.

Case Report: Testicular Torsion in Unilateral Supernumerary Testis

Supernumerary testis (SNT), or polyorchidism, is a rare congenital anomaly of the genitourinary tract, described as the presence of more than two testicles. Testicular torsion (TT) in unilateral SNT is extremely rare. We report a case of unilateral SNT in a 16-year-old boy accompanied by TT, which was diagnosed preoperatively based on the outcomes of physical examination and ultrasound and confirmed intraoperatively. We opted for orchiectomy of this SNT because of the long-time hypoperfusion. And as for the normal testis, orchidopexy was performed. His clinical presentation subsided after surgery, and the patient was discharged 3 days later.

[PUBERTAL TESTICULAR TORSION OF POLYORCHIDISM DIAGNOSED IN INFANCY: A CASE REPORT]

Left polyorchidism was found in a 2-month-old boy with a left scrotal mass. As he was asymptomatic and all testes were in the scrotum, he was conservatively followed up. At 17 years of age, he presented with left acute scrotum due to testicular torsion of the left supernumerary testis. Counterclockwise 720-degree rotation of the left supernumerary testis was noted during emergency surgery, and orchidopexy of the 3 testes (2 left testes and 1 right testis) was performed. Biopsy of the left supernumerary testis demonstrated spermatogenesis and no malignancy. One and a half years after surgery, all testes were viable without atrophy.Polyorchidism is a rare condition and there is no consensus on the management of asymptomatic cases detected early in life. The position of the supernumerary testis (intrascrotal or extrascrotal) is important when deciding the management strategy because of the risk of malignancy. If conservative management is selected initially, elective surgery, such as prophylactic orchiectomy or orchidopexy, may be needed because of the risk of malignancy and torsion.

Management of Bilateral Undescended Bilobed Testes and Review of the Literature

Polyorchidism is a rare anomaly of testicular development. Particularly, a bilobed testis is an extremely rare congenital malformation, which is thought to be a variant expression of polyorchidism. Only 5 cases of bilobed testis have been reported in the literature to date. This report is of bilateral, undescended, bilobed testes in a 15-month-old boy who has multiple other malformations of possible genetic etiology.

A bilobed testicle diagnosed with ultrasound in an 18-year-old boy

Bilobed testicle is a very rare congenital malformation with an unknown etiology. Herein, we report an 18-year-old boy presented with a right-bilobed testicle mimicking a testicular tumor. The present case highlights the importance of considering bilobed testicle as a valuable differential diagnosis of testicular mass to prevent unnecessary surgery. Furthermore, the case could provide more information about presentation and management of bilobed testicle.

Management of a bilobed testicle in a 12-year-old boy

A bilobed testicle is an extremely rare congenital malformation, with only five cases published to date. We present the case of a 12-year-old boy with a bilobed testicle. With so few cases available, much of what is known about the management of this condition is based on cases of polyorchidism and the complications associated with this, including malignancy and torsion. Whilst surgery may play a role in some patients, uncomplicated cases can be managed conservatively. There is no long-term data on the outcome of conservative management but we propose this patient can be discharged if no further changes are identified after 18 months.

Triorchidism: a rare genitourinary abnormality

Polyorchidism is an extremely rare congenital anomaly which refers to the presence of more than two testicles. There are very few reports of triorchidism in a 2 year old child. Polyorchidism is usually discovered incidentally. The most common anomalies associated with polyorchidism are inguinal hernia (30%), maldescended testis (15% to 30%), testicular torsion (13%) and hydrocele (9%). A 2-year-old child was brought with bilateral undescended testis with normal milestones. Ultrasonography of scrotum and abdomen showed both the testes to be in inguinal canal. Intra-operatively, on left side - there were two testes, which belonged to Leung III class and one testis on right side. Management of polyorchidism is still controversial. The management of polyorchidism will depend upon the location, size and anatomical organisation of the testicular drainage system and the age of the patient.