A Unique Case of Intraabdominal Polyorchidism: A Case Study

Abstract

Background. Polyorchidism, alternatively supernumerary testes (SNT), is a condition where an individual is born with more than two testicles. This congenital anomaly is quite rare and the literature has described various presentations. Questions/Purposes. To our knowledge, this presentation of polyorchidism has yet to be described in the literature. The goal of this case study is to add to the pediatric, general, and urologic surgery's body of knowledge of the subject matter. Case Study. A nine-month-old boy was admitted for an impalpable right testis and phimosis. At the time of surgical exploration, there appeared to be polyorchid testis on the right-hand side, with three masses that potentially appeared to be undescended testes. Discussion. Proponents of a conservative approach argue that infertility is common in patients with polyorchidism and, by preserving a potentially functional SNT, there may be improved spermatogenesis. When performing definitive surgical treatment, meticulous intra-abdominal and intrainguinal exploration must be undertaken. Orchiopexy should be performed to reduce the chances of torsion, malignancy, and infertility. Conclusion. Our case is important to the literature as it is the first known case of polyorchidism with 3 SNT on the right side, located intra-abdominally, and in a patient less than 1 year of age.

An unusual case of quadruple polyorchidism in a human cadaver mimicking bilateral lipoma

“…Thus, it is suggested to add a novel Type 3 with Tonape et al, 2012;Dollard, 2011;Sakamoto et al, 2007;Mittal et al, 2018;Otero, 2016;Artul and Habib, 2014;Hassan et al, 2014;Hassan et al, 2008). This suggests that some SNTs may be clinically misdiagnosed as lipomas, and therefore are more prevalent than previously recorded.…”

“…Polyorchidism often has no symptoms outside the extra testis. When symptoms are present, they may include pain in the scrotum or lower abdomen, or an obvious mass within the scrotum detected upon palpation (i.e., testicular examination) (Dollard, 2011;Sakamoto et al, 2007;Mittal et al, 2018;Otero, 2016). Associated inguinal hernia or undescended testis are not uncommon findings (Artul and Habib, 2014).…”

A Child with 3 Testes: Polyorchism

“…Around 15% of these cases present with testicular torsion and only 16% of the cases reported as asymptomatic. [6] If suspected, supernumerary testicles should be confirmed by an ultrasound or MRI. Like undescended testes, non-functional extra testicles may also give rise to a neoplasm.…”

“…Considering the common occurrence of infertility in polyorchids, it's safe to say that preservation of extra testicle may improve fertility. [6] Hence, surgical excision, or conserving the viable testis, the decision regarding management should be made by patient or guardians. And it should be based on suspected fertility status, as well as the possibility of close observation for any malignant transformation.…”

Two halves of a whole: Bilobed testis case report and implications in management of a rare condition

“…1 Although the exact etiology of bilobed testicle has not been elucidated, it is postulated to be a subtype of incomplete polyorchidism - another rare congenital malformation with less than 200 cases reported. 2 Embryologically, the etiology of polyorchidism is understood as aberrant division or multiplication of the genital ridge, likely due to a peritoneal band. 3 Thus, bilobed testis likely arises from incomplete division of the genital ridge secondary to a peritoneal band.…”