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. 2018:53:345-347.
doi: 10.1016/j.ijscr.2018.10.082. Epub 2018 Nov 13.

Neoplasm of a supernumerary undescended testis: A case report and review of the literature

Hamza Boussaffa  1 , Sahbi Naouar  2 , Nidhal Ati  2 , Mohamed Amri  2 , Badereddine Ben Khelifa  2 , Braiek Salem  2 , Rafik El Kamel  2
Affiliations

Neoplasm of a supernumerary undescended testis: A case report and review of the literature

Hamza Boussaffa et al. Int J Surg Case Rep. 2018.

Abstract

Introduction: Polyorchidism, defined as the presence of more than two testicles, is a rare congenital abnormality of the male genital tract. There is no consensus regarding the management of supranumerary testis (SNT) due to its rareness. To the best of our knowledge, this is the first report of leiomyoma in SNT.

Presentation of case: We report the case of a 41-year-old man with two right testes sharing a common vas deferens and separate epididymides. Orchiectomy of right testes was performed. Pathology examination found that the superior testis was the site of a leiomyoma and the lower tesits was the site of an intratubular germ cell neoplasia (IGCN). Orchiopexy and biopsy were later performed for the left testis. Histology was compatible with IGCN. We opted for follow-up to avoid risks of hypogonadism.

Discussion: Polyorchidism is usually asymptomatic and found incidentally during surgery for inguinal hernia, undescended testes as in our case, torsion, hydrocele or testicular tumor. If the SNT is scrotal, and there is no other indication for surgery, most authors recommend conservative management with regular ultrasound follow-up. If nonscrotal SNT is found incidentally during surgery, orchiectomy could be performed because of increased risk of malignancy. Treatment of IGCN includes surveillance, orchiectomy, or low-dose external radiation.

Conclusion: Different factors come into account for polyorchidsm management: the drainage system, the fertile potential of the supernumerary gonad, and its localization. In cases of uncomplicated polyorchidism, a conservative treatment, with US or MRI follow-up seems to be a rational choice without surgical complications.

Keywords: Case report; Neoplasm; Supernumerary testis; Undescended testis.

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Figures

Fig. 1
Fig. 1
Intra-operative findings after right inguinal incision.
Fig. 2
Fig. 2
The two right testes after orchiectomy. The inferior testis in the image is dysmorphic and suspicious, while the superior testis seemes macroscopically normal. The inferior testis drains into the epididymis of the superior testis with a common vas deferens.
Fig. 3
Fig. 3
A complete separation between the epididymis and the left testis with a mesentery. If nonscrotal SNT is found incidentally during surgery, orchiectomy could be performed because of increased risk of malignancy
See this image and copyright information in PMC

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