A 44 year old male patient, whose personal history included testicular trauma in childhood which did not require surgery. He presented with an increase in the size of the right hemiscrotal associated with slight testicular discomfort for the last 7 months and self-palpation of a right paratesticular mass.
Physical examination revealed a penis with no findings of interest, a left teste of normal size, mobility and consistency, and an enlarged right hemiscroctum with a normal teste and an adjacent structure in the upper pole separate from the theoretical right teste, not indurated or painful to the touch.
In order to make a first approximation to the diagnosis, germinal tumour markers were requested, with normal results, and a testicular ultrasound scan showed a structure adjacent to the right teste in its upper pole that was differentiated from it, smaller in size and ultrasonographically similar to the teste, associated with a right hydrocele, so that the initial suspicion was of polyorchidism with associated hydrocele.

A CT scan was also performed, showing two structures of similar appearance in the right hemiscrotal area, one of which was smaller than the other, with no other exploratory findings of interest.

An exploratory scrototomy was performed, showing a right hydrocele and two interrelated structures, compatible with teste, sharing epididymis and deferens. A biopsy was taken of the smaller structure and eversion of the vagina was performed to resolve the hydrocele. The pathological anatomy showed preserved testicular tissue with no signs of atrophy.