Conservative Management of Intrascrotal Polyorchidism in a 14-Year-Old Boy: A Case Report and Review of the Current Literature.

Abstract

Polyorchidism, or supernumerary testes (SNTs), is a rare congenital condition, management of which remains debated, particularly in paediatric cases with other concomitant features. We report a case of intrascrotal polyorchidism in a 14-year-old boy managed surgically due to parental preference and the need for histological confirmation. The patient presented with a 2-week history of painless heaviness in the scrotum. Physical examination and Doppler ultrasonography revealed a 1.8 cm mass fused to the inferior pole of the left testicle with associated Grade 1 varicocele, hydrocele and testicular appendix. Although MRI of the scrotum was initially offered, the family declined in favour of timely histological confirmation. Surgical exploration confirmed a fused supernumerary testicle and a biopsy showed normal spermatogenesis; this was consistent with Type A3 triorchidism. The patient had no complications or recurrence of symptoms at 12-month follow-up. This case highlights the use of surgical exploration in selected intrascrotal polyorchidism cases where imaging can be inconclusive or histological confirmation is required. Parental concerns and long-term reassurance may also reasonably influence management decisions.