Polyorchidism

A 7-year-old boy presented with two testicles on the left side of the scrotum. The superior one was half the size of the inferior one, which measured 2 × 1 cm. The testicle on the right side measured 2 × 1 cm. Surgical exploration was done, and the atrophic left supernumerary testicle shown in the photo was removed. Biopsy specimens taken from the remaining testicle were normal.

Triorchidism is the most common type of polyorchidism, but patients with five testicles have been reported. In about 75% of reported cases, polyorchidism has been left-sided. This tendency may be related to the reportedly greater size of the left testicle, which may subdivide more readily.

Because of the high incidence of torsion, the theoretic risk of malignancy, and the histologic abnormality of most supernumerary testes, most authorities recommend surgical exploration and removal of the supernumerary testis and, in cases of atrophy, removal of both the supernumerary testis and the adjacent testis. The normal-looking contralateral testis should be subjected to biopsy and fixation in the scrotum. If the biopsy results are abnormal, surgical excision of the testis or close follow-up is warranted.