Presentation
Bilateral testicular lump, noticed 2 weeks before, no pain or discomfort, on examination bilateral testis and cord normal.
Patient Data
Bilateral para testicular lesions, having echogenicity almost similar to testes with complex cystic foci on the left side.
There is a 13 x 11 x 12 mm well defined para testicular lesion at the inferior aspect of the right testicle. This does appear to have a low signal intensity capsule most likely the tunica albuginea.
This has a signal intensity equivalent to testicular parenchyma and is homogenous early T2 mildly hyperintense.
This demonstrates enhancement pattern and diffusion characteristics equivalent to testicular parenchyma.
A 13 x 11 x 12 mm partially cystic lesion is seen in the posterior aspect of the left hemi scrotum. This could represent a mediastinum testis within an accessory testicle also. This is part solid part cystic. The solid component shows similar signal characteristics to testicular parenchyma.
Conclusion:
Bilateral para testicular lesions are - the left showing a cystic focus.
Features are likely to represent accessory testes (polyorchidism).
Case Discussion
Polyorchidism is a very rare congenital disorder. The accessory testes can be in the scrotum or extra-scrotal. It is associated with inguinal hernia, cryptorchidism (15%), testicular torsion and testicular malignancy.