Polyorchidism: a three-case report and review of the literature

Abstract

The presence of more than two testes confirmed by histology is called polyorchidism. Polyorchidism is an extremely rare congenital anomaly with a few more than 100 cases reported in the literature. The majority of reported cases are asymptomatic patients, others present with cryptorchidism, hydrocele, varicocele, epididymitis, infertility, testicular malignancy and testicular torsion. Over a 2-year period, we encountered three patients who were found to have polyorchidism; two men presented with cryptorchidism and one with chronic scrotal pain. Physical examination of the first and the third patient revealed normal testes in the scrotal sac, the other scrotal sac was empty and small solid mass (atrophic left testes) was palpated in the inguinal canal. Ultrasonographic examination of the scrotum and inguinal region confirmed the findings of the physical examination. Ultrasonographic examination of the second patient revealed supernumerary testes within the scrotum. Orchiectomy was made on the first and third patients' supernumerary testes and ipsilateral inguinal high ligation was applied for herniorrhaphy. A conservative approach was preferred for the second patient, maybe preserving a potentially functional supernumerary testis to improve the capacity for spermatogenesis. The risk of malignancy justifies the removal of an atrophic and ectopic testis in polyorchidism. However, it would appear safe to preserve a viable intrascrotal supernumerary testis found incidentally at surgery, provided that the patient is followed-up in the long term.

Testicular and paratesticular tumors and tumor-like lesions in the first 2 decades

“…255,256 About 75% are intrascrotal, and the remaining cases are either inguinal (20%) or abdominal (5%). 257 There is a leftsided predominance (65%). 258 They may present as palpable masses superior to the normally situated testis, but they are also frequently found during surgery for other indications including inguinal hernia repair, torsion, and pain.…”

Polyorchidism

“…Skrotal yerleşimli çoğul testislerin değer-lendirilmesinde malignite riski görülmüyorsa takip edilmesi yeterlidir (2,5,6). …”

“…Türkiye'den bugüne kadar bildirilmiş poliorşidizm vakası 10 kadardır. Çoğul testisler ektopik ya da atrofik olmaları halinde malignite riski oluş-tururlar (2). Biz bu yazıda üç testisi bulunan 20 yaşındaki hastamı-zın bulgularını literatür eşliğinde tartışmak istedik.…”

Triorchidism: two case reports

“…More than half of the histologically confirmed supernumerary testes were reported to have the potential for sperm production (Kharrazi et al ., ). The majority of reported cases are asymptomatic, while others present with pain, scrotal swelling, cryptorchidism, hydrocele, varicocele, epididymitis, infertility, testicular malignancy or torsion (Hassan et al ., ; Savas et al ., ).…”