Polyorquidism: case report comparing ultrasonography and magnetic resonance imaging

Abstract Introduction: polyorchidism is an unusual pathology, about 200 cases in the world literature. Case report: we reported a case of polyorchidism in a 16-year-old male patient diagnosed by ultrasound and confirmed by magnetic resonance imaging. Discussion: most of the cases presented, there is a supernumerary testis, but there are reports on more than three, up to five testicles with supranumerical gonads on both sides of the scrotum. The diagnosis is usually performed in late puberty, incidentally, with a painless scrotal mass or at the emergency room, presenting a testicular torsion of the whole hemiscrotum or supernumerary testisalone, and the differential diagnosis should be made with epididymal cyst and spermatocele, besides other extra-testicular masses (hydroceles, varicoceles, lipomas, tumors.) and para-testicular masses (hernias, scrotal calculi). After the initial clinical evaluation, ultrasound is the first line subsidiary exam. Magnetic Resonance Imaging is very helpful, just in case the ultrasound diagnosis is uncertain. The supernumerary testishave the same Magnetic Resonance Imaging characteristics as the normal testes (intermediate signal intensity on T1- weighted images and high signal intensity on T2-weighted images).摘要与引言：多睾症（polyorchidism）是一种罕见的病理病症，全球已发表文献报道约200例。病例报告：本文报道1例16岁男性多睾症患者，经超声（ultrasound）诊断，并经磁共振成像（Magnetic Resonance Imaging）确认。讨论：多数已报道病例仅存在1枚额外睾丸，但亦有文献提及超过3枚额外睾丸的案例，最多可在双侧阴囊内出现共计5枚附加性腺。该病通常于青春期后期偶然确诊，患者可表现为无痛性阴囊肿块，或因单侧阴囊整体睾丸扭转、单独额外睾丸扭转而就诊于急诊。鉴别诊断需与附睾囊肿、精子囊肿，以及其他睾丸外肿物（鞘膜积液、精索静脉曲张、脂肪瘤、肿瘤等）和睾丸旁肿物（疝、阴囊结石）相区分。完成初步临床评估后，超声为首选辅助检查手段。若超声诊断存在不确定性，磁共振成像可提供显著辅助价值。额外睾丸与正常睾丸具有一致的磁共振成像特征：T1加权成像（T1-weighted images）呈中等信号强度，T2加权成像（T2-weighted images）呈高信号强度。