Hirata Yurie, Moriya Kimihiko, Nakamura Michiko, Kon Masafumi, Nishimura Yoko, Ujihashi Kazuhiro, Higuchi Madoka, Matsumoto Ryuji, Kitta Takeya, Shinohara Nobuo
Department of Renal and Genitourinary Surgery, Graduate School of Medicine, Hokkaido University.
Nihon Hinyokika Gakkai Zasshi. 2020;111(2):53-57. doi: 10.5980/jpnjurol.111.53.
Left polyorchidism was found in a 2-month-old boy with a left scrotal mass. As he was asymptomatic and all testes were in the scrotum, he was conservatively followed up. At 17 years of age, he presented with left acute scrotum due to testicular torsion of the left supernumerary testis. Counterclockwise 720-degree rotation of the left supernumerary testis was noted during emergency surgery, and orchidopexy of the 3 testes (2 left testes and 1 right testis) was performed. Biopsy of the left supernumerary testis demonstrated spermatogenesis and no malignancy. One and a half years after surgery, all testes were viable without atrophy.Polyorchidism is a rare condition and there is no consensus on the management of asymptomatic cases detected early in life. The position of the supernumerary testis (intrascrotal or extrascrotal) is important when deciding the management strategy because of the risk of malignancy. If conservative management is selected initially, elective surgery, such as prophylactic orchiectomy or orchidopexy, may be needed because of the risk of malignancy and torsion.
在一名患有左侧阴囊肿块的2个月大男婴中发现了左侧多睾症。由于他没有症状且所有睾丸都在阴囊内,因此对其进行了保守随访。17岁时,他因左侧多余睾丸发生睾丸扭转而出现左侧急性阴囊症状。急诊手术中发现左侧多余睾丸逆时针旋转了720度,并对3个睾丸(2个左侧睾丸和1个右侧睾丸)进行了睾丸固定术。左侧多余睾丸活检显示有精子发生且无恶性病变。手术后一年半,所有睾丸均存活且无萎缩。多睾症是一种罕见疾病,对于在生命早期发现的无症状病例的管理尚无共识。由于存在恶性病变风险,在决定管理策略时,多余睾丸的位置(阴囊内或阴囊外)很重要。如果最初选择保守治疗,由于存在恶性病变和扭转风险,可能需要进行择期手术,如预防性睾丸切除术或睾丸固定术。