Perineal Ectopic Testis in a Four-Year-Old Boy: Surgical Anatomy and Orchidopexy — A Case Report

Perineal ectopic testis is an uncommon anomaly of testicular descent that may be overlooked when examination is limited to the inguinal canal. We describe a four-year-old boy with an empty left hemiscrotum and a mobile superficial perineal mass. Ultrasonography identified testicular tissue at the ectopic site. A combined inguinal and scrotal surgical approach demonstrated a normally formed testis, epididymis, and vas deferens, an unusually long spermatic cord, and an aberrant gubernacular attachment to the perineum. No patent processus vaginalis was identified. After division of the ectopic gubernacular attachment, the testis was transferred and fixed in the left scrotum. At approximately one year, both testes were clinically scrotal and symmetric. This case highlights the diagnostic value of perineal palpation and the importance of identifying the gubernacular attachment during orchidopexy.