Polyorchidism: A Case Report on Diagnostic Approach and Surgical Considerations

Polyorchidism is a rare developmental anomaly in which more than two testes are present, usually diagnosed incidentally through imaging. The most frequent presentation is triorchidism, with the supernumerary testis typically located within the scrotum or inguinal canal. Embryologically, the condition is attributed to abnormal partitioning of the genital ridge during early development, specifically before the eighth week of gestation. Ultrasonography remains the initial imaging modality of choice, with MRI providing further diagnostic clarity if needed. We report the case of a 4-year-old male with a history of right cryptorchidism and prior orchidopexy, in whom left-sided polyorchidism was incidentally detected during ultrasound assessment of an atrophic right testis. Management is determined by associated anomalies and the risk of malignancy; conservative surveillance is generally recommended for morphologically normal, scrotal testes, whereas surgical intervention, including orchiectomy, is reserved for extrascrotal locations, atrophic gonads, or when malignancy is suspected.