Do We Need Laparoscopic Abdominal Exploration for a Testicular Nubbin Palpated in the Inguinal Region? A Case with Type IV Polyorchidism

Introduction

Physical examination for nonpalpable testis sometimes reveals a testicular nubbin in the inguinoscrotal region. Palpation does not always mean that routine inguinal exploration is sufficient for both diagnosis and treatment.

Polyorchidism is a rare pathology with only 100 cases reported to date [2]. According to one of the theories discussing the possible embryological basis of polyorchidism, the anomaly occurs following a transverse division of the primitive gonadal ridge [3]. Polyorchidism is classified depending on the extent and locus of the division. There are 4 types; type IV is the rarest with complete duplication of the testis, epididymis and vas deferens. According to a review of the literature, only 5% of supernumerary testes are intra-abdominal [5]. We present a case with type IV unilateral polyorchidism. The patient presented with a testicular nubbin in the inguinal canal which proved to be an intra-abdominal testis.

References

• 1 Bergholz R, Koch B, Spieker T. et al . Polyorchidism: A case report and classification.  J Pediatr Surg. 2007;  42 1933-1935
• 2 Kumar B, Sharma C, Sinha DD. Supernumerary testis: A case report and review of literature.  J Pediatr Surg. 2008;  43 E9-E10
• 3 Leung AK. Polyorchidism.  Am Fam Physician. 1988;  38 153-156
• 4 Marshall FF, Weissman RM, Jeffs RD. Cryptorchidism: The surgical implications of non-union of the epididymis and testis.  J Urol. 1980;  124 560-561
• 5 Thum G. Polyorchidism: Case report and review of literature.  J Urol. 1991;  145 370-372

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