Transverse testicular ectopia in a fertile elderly male presenting with incarcerated inguinoscrotal hernia

Transverse testicular ectopia is a rare congenital anomaly characterized by the unilateral descent of both testes into one hemiscrotum. Fewer than 100 occurrences of this condition have been reported worldwide, almost all of them in children. In this report, we describe transverse testicular ectopia (TTE) identified in a 55-year-old, apparently fertile, male who presented to a rural hospital in Belladere, Haiti, for elective repair of an incarcerated left inguinoscrotal hernia. Preoperative palpation of the scrotum had revealed apparently normal, well-developed left and right testicles. However, during open herniorrhaphy, both testicles were found to have descended on the left side and reside in an enlarged left hemiscrotum. Surgeons who frequently repair inguinal hernias should be aware of this rare clinical entity and its recognized association with inguinal hernia; they should also be aware of the appropriate surgical management options available to them when this condition is unexpectedly identified during inguinal exploration.