Right-Sided Triorchidism: A Rare Case of Supernumerary Testis in a Young Adult Male

TL;DR

A 22-year-old male was found to have three testes, a rare condition called triorchidism, diagnosed using ultrasound and managed conservatively due to normal findings.

Contribution

This case report highlights a rare right-sided triorchidism presentation and emphasizes the role of high-resolution ultrasound in its diagnosis.

Findings

Scrotal ultrasonography confirmed two morphologically normal testes with distinct structures on the right side.

No evidence of malignancy or torsion was found, supporting conservative management over surgical intervention.

The case underscores the importance of clinical awareness to avoid unnecessary surgery in asymptomatic triorchidism.

Abstract

Triorchidism is an exceptionally rare subtype of polyorchidism, defined by the presence of three testes. Most cases are identified incidentally during evaluation for unrelated scrotal symptoms or imaging studies. Although generally benign, this anomaly has diagnostic and management implications because of potential associations with torsion, cryptorchidism, and malignancy. We report a case of a 22-year-old male who presented with intermittent right scrotal discomfort. Examination revealed a normal left testis and two distinct right-sided testes. Scrotal ultrasonography demonstrated two morphologically normal testes with preserved vascularity, homogeneous echotexture, and separate epididymal and ductal structures. Serum tumour markers were within normal limits, and no radiological features suggestive of neoplasia were observed.

The presence of a supernumerary testis is thought to result from segmental duplication of the genital ridge during early gonadal development. When the additional testis is scrotal and radiologically benign, current evidence supports conservative management with routine self-examination and clinical follow-up. Surgical excision is generally reserved for cases with suspicious imaging features or undescended, dysgenetic testes due to the increased risk of malignancy. This report highlights a rare right-sided presentation of triorchidism and reinforces the value of high-resolution ultrasonography in diagnosis. Awareness of this uncommon entity is essential to avoid unnecessary surgical intervention and to preserve fertility potential in otherwise asymptomatic patients.

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