Bilateral Enlarged Testes: A Case Report

Background: The major components of the male reproductive system consist of the penis, scrotum, testes, and the epididymis. The testicles begin in the abdominal cavity in the fetus and descend through the processus vaginalis in the abdominal wall. If the processus vaginalis remains patent after birth, this can predispose a person to indirect inguinal hernias of the intestine. Case Information: During a routine cadaver dissection, a 76-year old male presented with bilateral enlarged testes, both nearly five times the size of an average male testis. Removal of the outer layers of the scrotum revealed solidified green, yellow, and grayish purulent exudate surrounding both testes between the layers of the parietal and visceral tunica vaginalis. The presentation of both testes differed greatly. The left testis was easily compressible and had a large varicocele, while the right testis was turgid and contained a large hematoma. The inferior pole of the left testis had extensive fibrous scarring and epididymal-testis junction and the anterior surface of left testis had two small nodules protruding from the tunica albuginea. In addition to the findings within the reproductive system, an indirect inguinal hernia was identified within the right spermatic cord. Conclusion: We believe the cause of the bilateral enlarged testes were from two different sources rather than a single disease or incident, due to the stark differences between the two. This case report attempts to further the understanding of the causes of enlarged testes and the relationship between gastrointestinal and reproductive disorders.