Transverse testicular ectopia with persistent müllerian duct syndrome: a case report

Area of Science:

• Urology
• Developmental Biology
• Medical Imaging

Background:

• Transverse testicular ectopia (TTE) is a rare condition where both testes are found in a single scrotum.
• Persistent Müllerian duct syndrome (PMDS) is a congenital disorder in males characterized by the presence of Müllerian duct remnants.
• TTE is a recognized clinical manifestation of PMDS.

Purpose of the Study:

• To report a case of PMDS diagnosed in an adult male based on TTE.
• To investigate the relationship between TTE, Müllerian duct remnants, and testicular torsion in an adult.
• To explore the potential mechanisms of TTE development in PMDS, including its occurrence after testicular descent.

Main Methods:

• Computed tomography (CT) and magnetic resonance imaging (MRI) were used to evaluate pelvic and scrotal structures.
• Surgical exploration was performed to confirm imaging findings and manage testicular torsion.
• Histological examination and immunostaining were conducted on the removed testis and associated tissues.

Main Results:

• The patient presented with TTE and a pelvic structure suggestive of Müllerian duct remnants.
• Imaging revealed the right testis ectopically located within the left scrotum, enlarged and torsed.
• Histology confirmed a seminoma in the torsed right testis and identified attached Müllerian duct remnants.
• TTE was determined to have occurred after completed testicular descent, linked to Müllerian remnants and a presumed long gubernaculum.

Conclusions:

• This case supports the theory that Müllerian duct remnants and an abnormally long gubernaculum contribute to TTE in PMDS.
• The findings suggest that TTE can manifest even after the completion of testicular descent.
• This report adds to the understanding of the pathophysiology of TTE in the context of PMDS.