Radiologic evaluation of scrotal lesions: A case of polyorchidism with abnormal ultrasound findings

Supernumerary testis (SNT), or polyorchidism, is a rare congenital condition characterized by the presence of 3 or more testes. Here, we present the case of a 53-year-old man with a history of prostate cancer who presented with a painless right-sided scrotal mass and abnormal ultrasound (US) findings. US imaging showed a heterogeneous and hyperechoic paratesticular mass, initially raising concern for a SNT, primary neoplasm, or metastatic process. Magnetic resonance imaging (MRI) was obtained for further evaluation of suspicious features and ultimately confirmed the diagnosis of SNT, allowing for conservative management. Given the imaging findings, the patient did not require surgical intervention and continued routine follow-up with annual testicular exams and prostate-specific antigen levels.