Management of a bilobed testicle in a 12-year-old boy
A 12-year-old boy was referred by his GP to the paediatric surgery clinic in a district general hospital with a 6-week history of a lump near the inferior pole of his left testicle. It was non-tender, non-erythematous and had not changed in size or consistency. He was otherwise fit and well, with no family history of urological disorders. On examination, his abdomen was soft and non-tender, with a normal right testis and right spermatic cord. A smooth well-defined lump was palpated on the inferior pole of the left testis. The rest of the testicle had a normal consistency with a normal left cord. Ultrasound demonstrated that both testicles were of a similar size, with normal vascularity and normal epididymi. The palpable lump corresponded to a well-defined 1-cm mass attached to the lower pole of the left testicle (Fig. ). It had a similar echo pattern to the testicle with normal vascularity (Fig. ), consistent with the finding of a bilobed testis.\nThe boy was reviewed 3 months later in outpatient clinic. The size of the lump was unchanged, although he now reported intermittent pain and swelling of the lump. He was referred to a consultant paediatric urologist and his testicle rescanned 6 months after his initial presentation. He was asymptomatic at this time. The ultrasound findings were unchanged and confirmed normal testicular architecture. He will be reviewed again in 12 months, with a view to discharging him if no further changes are seen.