0:00

Old male with scrotal swelling.

0:04

So in all the patients who get scrotal ultrasound,

0:07

we always image kidneys because sometimes the renal disease can, um,

0:12

present like scrotal. So the kidneys were all normal.

0:17

Um,

0:19

and here is the scrotal image.

0:24

So in the, as we do the buddy image, what is the buddy image,

0:28

we put the trans user right in the center of the scrotum and do a transfer

0:33

section right there.

0:34

So this is our first image and we see multiple,

0:40

well-defined, um, testicular

0:49

testes like, uh, structures, multiple. That's the epi.

0:55

So we were a hundred percent sure that the right side is,

0:58

this one is the testes, and the left side is also we could see a, uh,

1:02

definite shape of testes on the left side. However, there was a big area,

1:07

this is the midline. You can see a big lesion there.

1:10

Lesion hypoechoic area.

1:14

And we found two more.

1:20

So on colored ocular examination, there was no abnormal vascularity,

1:23

no hydrocele, no signs of scrotal inflammation. The patient, uh,

1:28

presented, uh,

1:29

to get evaluated for scrotal mass and swelling.

1:34

So, um, can we bring the poll question?

1:38

So what is the most likely diagnosis? We are,

1:41

we are definitely sure that we are looking at two testes left and right,

1:45

but then, then there are additional, um, lesions, masses,

1:50

mass like structures, uh, which we saw on ultrasound total of five.

1:55

So what could it potentially be? Yeah,

2:00

absolutely extra testes.

2:05

So the

2:10

poly orchard or supernumerary testes is incidentally detected as in our

2:14

patient. Um,

2:16

it should not be because all the newborn screens do include, um,

2:20

evaluating the testes and their location. Uh, when there is poly orchard,

2:25

you can see all the testes in ectopic location.

2:29

So the pa the patients can present with crypto. Um,

2:34

some of the testes may be located in the inve region or intraabdominal and few

2:38

may be located in the scrotum. Um, the ones which are, um,

2:43

located in the scrotum have a higher propensity of torsion undergoing torsion,

2:48

varial formation infer and tumors can happen in any of these. Um,

2:53

testes. There is a higher risk in patients who have poly aism. Uh,

2:57

they can have all these

2:58

Testes, at least on one side, can have common EPIs and VAs deference.

3:03

So whatever the complications we see from, um, um,

3:07

any kind of complications we can be seen in the scrotum can be seen in these

3:10

patients who have poly charism.

3:12

Just you have to multiply those incidents by multiple because of, uh,

3:16

multiplicity and supernumerary, um, ornaments.