Polyorchidism discovered as testicular torsion

Shah, Sanjay N.; Miller, Barnett M.; Geisler, Edward

doi:10.1016/0090-4295(92)90012-l

Cited by 24 publications

(15 citation statements)

References 17 publications

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“…The more common anomalies associated with polyorchidism are maldescent of one of the supernumerary testes (15%-50%) and inguinal hernia (30%) (3). Torsion has been reported in up to 13% of cases (7). Because abnormal fixation of the testes by the tunica vaginalis tends to be bilateral, orchiopexy is often performed bilaterally (8).…”

Section: Discussionmentioning

confidence: 99%

Case 82: Polyorchidism with Torsion

Hwang

Aronoff²,

Leonidas³

2005

Radiology

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A 15-year-old boy presented to the emergency department with acute left scrotal pain of 12 hours duration. He had previous intermittent pain, without scrotal swelling. Physical examination revealed a normal right testis. The left testis was palpable within the hemiscrotum, but there was a tender indurated mass in continuity with the epididymis. There was minimal swelling of the left side of the scrotum without erythema. Bilateral cremasteric reflexes were present. All laboratory values were unremarkable. Scrotal ultrasonography (US) was performed. IMAGING FINDINGSUS demonstrated one normal right testis and two left testes, one in the upper hemiscrotum and one in the lower hemiscrotum (Figs 1-4). The right testis was unremarkable in echogenicity, with normal blood flow on the color Doppler flow image (Fig 1). Both left testes demonstrated similar homogenous echogenicity; however, there was no color flow in the left upper testis, a finding that is compatible with testicular torsion. This finding corresponded to the tender indurated mass found at physical examination (Figs 2, 5). Figures 4 and 5 also show a part of the epididymis attached to the upper testis. The lower testis had normal blood flow (Fig 3). A moderate hydrocele was seen in the upper portion of the hemiscrotum (Fig 2). DISCUSSIONFollowing US examination of the scrotum, the patient underwent urgent left scrotal exploration. The intraoperative findings revealed a duplicated testis within the left portion of the scrotal sac, which was complicated by torsion of the upper testis (Fig 6). The lower testis was normal (Fig 3). The head of the epididymis was attached to the upper testis, and it had also undergone torsion (Figs 4 -6). The remaining body and tail of the epididymis was attached to the lower testis, which had not undergone torsion (Fig 6). The upper testis was believed to be viable after torsion was treated, and orchiopexy was performed. Biopsy of the upper testis revealed normal spermatogenesis and seminiferous tubules. Since the US examination revealed a single normal right testis with normal blood flow and the results of physical examination were unremarkable, surgical exploration of the right hemiscrotum was not performed.The differential diagnosis for a painful scrotal mass includes-in descending frequency-inflammation, hydrocele, torsion, varicocele, spermatocele, cysts, and malignant or benign tumor (1). US is the modality of choice in the evaluation of the acute scrotum. In particular, the differentiation of intraand extratesticular masses has a sensitivity of 80%-95% (1). In this case, the absence of abnormal focal intratesticular echotexture excluded intratesticular tumor. There is no US finding suggestive of varicocele, spermatocele, or cysts. There is also no indication of increased Doppler flow suggestive of inflammation. The most salient finding is the presence of a well-defined mass that has echotexture similar to that of the adjacent normal testis, and it has no blood flow. Although there is a moderate hydrocele, the presence of th...

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Section: Discussionmentioning

confidence: 99%

Case 82: Polyorchidism with Torsion

Hwang

Aronoff²,

Leonidas³

2005

Radiology

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“…Although rare, there have been several reviews in the literature. [6][7][8] Individual case reports have shown polyorchidism to present as a painless mass, 9 torsion, 7,10-14 inguinal hernia 15 or malignancy. 16 The patient's age at presentation has been variable and treatment is generally surgical.…”

Section: Discussionmentioning

confidence: 99%

Two primary seminomas in a patient with polyorchidism

Ghose

Rodrigues

Izawa

2012

CUAJ

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We report the clinical, radiographic and pathological findings of polyorchidismand a right-sided abdominal seminoma found in a 28-year-old man who presentedwith cryptorchidism in childhood and who later underwent an orchiectomyfor a left-sided seminoma. Pathological analysis of the abdominal tumour revealed the existence of a classic seminoma bordered by a rim of non-tumour tissue and remnants of epididymis. We propose that patients who present with cryptorchidism be assessed for polyorchidism as this might be the source of additional primary tumours.

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“…Other associated anomalies are inguinal hernia (30%), hydrocele (9%), vericocele (<1%), hypospadiasis (<1%), anomalous urogenital union (<1%) and extremely rare is malignancy (<1%). [17][18][19][20] Malignant transformation may occur within the supernumerary testis; irrespective of its location and most common reported neoplasm are embryonic carcinoma, germ cell tumor and seminoma. 21,22 Spermatogenesis in supernumerary testis is normal in about 50% of cases.…”

Section: Clinical Presentations Associated Anomalies and Complicationsmentioning

confidence: 99%