Minor lobulation of the testis, mimicking polyorchidism when inflammed, discussion of a rare case: A case report

INTRODUCTION: Bilobed testis is an uncommon congenital malformation with only eight cases reported up to now. It seems that bilobed testicle is a form of polyorchidism which is not yet thoroughly divided. This report could provide information about diagnosing minor lobulation on ultrasound and MRI for the first time. PRESENTATION OF CASE: In this report, a 13-year-old boy presented with extreme Epididymo-orchitis on the right testis, without any history, which showed itself on ultrasound as type A3 polyorchidism or bilobed testis. CLINICAL DISCUSSION: Recent studies have not shown an apparent association between bilobed testis with testicular torsion and malignancy. In our case, because the minor lobulation is small, it probably has no association with torsion. The bilobed testis seems benign, so there is no requirement to check tumor markers. An inflamed testicular appendix and epididymitis can appear similar to a major lobulation which must be accurately found and evaluated on ultrasound as separate entities. CONCLUSION: Inflamed minor lobulation of the testicle can demonstrate itself as polyorchidism or bilobed testicles; thus, Ultrasound and MRI can assist in diagnosing minor lobulation. Serial examination and imaging are recommended for managing minor lobulation.