Incidentally Detected Bilobed Testis in an Asymptomatic Adult Male: An Uncommon Variant of Polyorchidism

Bilobed testis is an extremely rare congenital anomaly considered an incomplete form of polyorchidism, resulting from incomplete division of the genital ridge during embryogenesis. Fewer than 250 cases of polyorchidism have been reported worldwide, and bilobed variants represent only a small proportion of these cases. Recognition of this benign anatomical variant is important to avoid unnecessary surgical intervention. We report the case of a 37-year-old asymptomatic male in whom a left scrotal mass was detected incidentally on clinical examination. Scrotal ultrasonography demonstrated a well-defined ovoid nodule adjacent to the posterior-inferior aspect of the left testis measuring 14 × 15 × 8 mm. The lesion demonstrated identical echogenicity and internal architecture to the adjacent testicular parenchyma, consistent with a bilobed testis. Follow-up ultrasonography at 18 months showed no interval change, confirming stability. Given the benign imaging features, absence of symptoms and stability on serial imaging, the patient was managed conservatively with reassurance and education regarding testicular self-examination. This case highlights the importance of recognising bilobed testis as a rare but benign congenital variant. Accurate radiological diagnosis can prevent unnecessary surgical exploration, reduce patient anxiety and preserve fertility.