Management of supernumerary testis: a rare case of polyorchidism in a 2-year-old boy

Abstract

Polyorchidism is a rare congenital abnormality described as the presence of three or more testicles. We report the case of a 2-year-old boy with intermittent left-sided scrotal swelling and an ipsilateral undescended testis. During the operation, a left cryptorchid testis was found at the external ring, with further dissection revealing a second vas deferens attached to an additional intrascrotal testis. The cryptorchid testis was pexied in the left hemiscrotum with the second descended testis left in place. A review of the literature reveals over 150 cases of supernumeracy testis. Triorchidism is the most common form with the third testis typically located within the scrotal sac. Supernumeracy testis is frequently associated with undescended testis, testicular torsion, inguinal hernia, and hydrocele. Management is controversial with some advocating for orchidectomy due to concerns of malignancy. The family was educated about the risk for malignancy and the importance of regular follow-up and testicular self examination starting at puberty.

Keywords: orchidectomy, orchidopexy, polyorchidism, supernumerary testis