An epidermoid cyst presenting as testicular torsion in a patient with tri-orchidism.

1 of 2 DESCRIPTION A 38-year-old male presented to the emergency department with acute onset of scrotal pain. The pain was excruciating. A prior scrotal ultrasound was consistent with polyorchidism ( fi gures 1 and 2 ). Clinical examination revealed a markedly distressed tearful man. Scrotal inspection showed three distinct scrotal masses, all of equivalent size, consistent with testes ( fi gures 3 and 4 ). The reported third testis was located in the left hemiscrotum. It was exquisitely tender and lay high in the midscrotum. All three masses had similar consistencies. At emergency scrotal exploration, two masses were identifi ed in the left hemiscrotum. There were no signs of testicular torsion. Incision of the third mass resulted in the expulsion of a copious quantity of thick brown material ( fi gures 5 and 6 ). Pathology showed a saccular 6 × 3 × 2 cm epidermoid inclusion cyst, lined by keratinised squamous Images in...