Presentation
Presented with constipation for 4 days with left abdominal pain. On examination noted suprapubic mass with left empty scrotum. Right testis was palpable.
Patient Data
The right testis is located within the right scrotal sac and appears normal with normal vascularity on Doppler. Normal right testicular size. The right epididymis appears normal. Minimal right hydrocele. The scrotal wall appears normal.
The left scrotal sac is empty.
An oval-shaped structure located at the suprapubic region with a similar echogenicity to the right testis. The structure is accompanied by viable epididymis, in keeping with ectopic testis. However, no vascularity was seen within the testis. No focal lesion was seen within the testis or epididymis. Anechoic fluid with septations was seen surrounding the ectopic testis. No wall-off collection.
No inguinal lymphadenopathy bilaterally.
The left orchiectomy was done. The left testis was sent for a histopathological test and no tumor was found.
The peritesticular pus was cultured and no organism was found.
Case Discussion
Ultrasound features are suggestive of an empty left scrotal sac with ectopic testis over the suprapubic region.
A left orchiectomy was done. Intra-operatively, the left spermatic cord was normal and healthy at the inguinal canal. The non-viable left testis was noted at the suprapubic region with unhealthy testicular dartos fascia. The testis was noted to have torsed epididymal cyst (so decided for left orchiectomy). Minimal pus at the subcutaneous region of the suprapubic exploration site.
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