Polyorchidism Presenting with Testicular Pain and Scrotal Mass Serdar Aykan 1 , Mustafa Zafer Temiz 2* , Murat Tuken 1 and Emrah Yuruk 1 1 Department of Urology, Bagcilar Training and Research Hospital, Bagcilar, Istanbul 2 Department of Urology, Bitlis State Hospital, Besminare, Bitlis, Istanbul * Corresponding Author: Mustafa Zafer Temiz, Department of Urology, Bitlis State Hospital, Besminare Mh. 13000, Besminare, Bitlis, Istanbul, Tel: +90 434 246 84 20; Fax: +90 434 246 84 24; E-mail: dr_mustafazafertemiz@hotmail.com Rec date: Jan 21, 2015, Acc date: Feb 23, 2015, Pub date: Feb 28, 2015 Copyright: © 2015 Aykan S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Polyorchidism is an extremely rare congenital anomaly of the urogenital system and is defined as the presence of more than two testes. The majority of patients are asymptomatic or present with painless inguinal or scrotal masses. We, hereby, report a 25-year-old triorchidism case who presented with testicular pain and a scrotal mass. Case report: A 25-year-old male patient was admitted to the outpatient clinic with the complaint of testicular pain and a scrotal mass. His medical history was unremarkable and there was no history of trauma. On physical examination, there were two palpable, ovoid, mobile, non-tender masses in the left hemiscrotum. Scrotal Color Doppler Ultrasonography revealed a 1.5 × 2.0 × 1.2 cm, well-circumscribed accessory tissue in the left hemiscrotum which had same echogenicity as the normal testes. Magnetic Resonance Imaging (MRI) also confirmed the tissue as the third testis. The patient was managed conservatively and put into a follow-up program. Conclusion: Polyorchidism is a rare congenital anomaly. Patients with polyorchidism can be managed conservatively unless there is no accompanying problems such as inguinal hernia, cryptorchidism or torsion. However, supernumerary testes should be removed if there is a suspicion for malignancy. Keywords: Scrotal mass; Testicular pain; Polyorchidism Introduction Polyorchidism is an extremely rare congenital anomaly of the urogenital system and is defined as the presence of more than two testes [1]. Its most common presentation is triorchidism [2]. The left side is predominantly affected. Approximately 50% of the cases are detected between 15 and 25 years of age [3]. The majority of patients are asymptomatic or present with painless inguinal or scrotal masses, undescended testis, and rarely, torsion of the supernumerary testis [4]. We, hereby, report a 25-year-old triorchidism case who presented with testicular pain and a scrotal mass. Case Presentation A 25-year-old male patient was admitted to the outpatient clinic of Bagcilar Training and Research Hospital, Istanbul with the complaint of testicular pain and a scrotal mass. His medical history was unremarkable and there was no history of trauma. On physical examination, his right testis was in normal shape and location; however, there were two palpable, ovoid, mobile, non-tender masses in the left hemiscrotum. There were no signs of inguinal hernia or hydrocele. Scrotal colour Doppler ultrasonography revealed a 1.5 × 2.0 × 1.2 cm, well-circumscribed accessory tissue in the left hemiscrotum which had same echogenicity as the normal testes. The accessory tissue had its own vascular system and epididymis draining to a common vas, suggestive of an accessory testis (Figure 1). Magnetic Resonance Imaging (MRI) also confirmed the tissue as the third testis (Figure 2). Figure 1: Color Doppler ultrasonography images of the left hemyscrotum: An extra smaller testicle with similar echo texture and vascular flow as the normal testes. Figure 2: Coronal magnetic resonance images of scrotum: T1/T2- weighted magnetic resonance images show three testes very clearly. The supernumerary testicle is smaller and it has similar intensity with normal right and left testes. Clinical Research & Bioethics Aykan et al., J Clinic Res Bioeth 2015, 6:2 http://dx.doi.org/10.4172/2155-9627.1000214 Case Report Open Access J Clinic Res Bioeth ISSN:2155-9627 JCRB, an open access journal Volume 6 • Issue 2 • 1000214