Rare Instance of Tri-orchidism: Detailed Case Study

In a recent medical case, a 29-year-old man presented with non-traumatic dull pain in the left hemiscrotum. After thorough clinical and sonographic examinations, the man was diagnosed with a rare condition known as tri-orchidism.

Tri-orchidism, an extremely rare anomaly of the urogenital tract, is characterised by the presence of three testes in the scrotal cavity. This condition, first reported in 1670, is the most common type of polyorchidism.

During the physical examination, a tender round lesion superior to the left testis was found. The right testis was found to be larger than both testes in the left hemiscrotum. On sonography, the left hemiscrotum demonstrated 2 small-sized testicles with homogeneous echo-texture and normal blood flow, each having a volume of 6 cc and 5.8 cc respectively. No evidence of hydrocele, varicocele, or any other pathology was found.

The complementary MRI revealed 2 round to oval shaped structures with signal characteristics identical to normal testicular tissue. The man was diagnosed with type II polyorchidism, a condition where the testes share an epididymis and vas deference.

Given the man's age and the need to maintain fertility, he was managed conservatively. This approach involves routine follow-up with instructions to report any changes in size, shape, or pain. In cases of suspected malignancy, an orchidectomy may be advised.

The exact cause of tri-orchidism is not known, but some suggest it may be due to early embryogenesis and the development of peritoneal bands. Less than 200 cases of tri-orchidism have been reported in literature, making each case a valuable contribution to medical knowledge.

The cause of the painful left hemiscrotum in the 29-year-old man diagnosed with triorchidism at the hospital was not disclosed. It is important to note that management of tri-orchidism depends on various factors and can include conservative treatment, orchidopexy, orchidectomy, or a combination of these.

This rare diagnosis serves as a reminder of the complexity and diversity of human anatomy, and the importance of thorough clinical examination and diagnostic tests in accurately diagnosing and managing such conditions.