Case Report
Crossed Testicular Ectopia (CTE) Associated with Persistent Mullerian Duct Syndrome (PMDS): Case Report with Review of Literature
Jyoti Narayan*, Shraddha R. Sinhasan, Shrinivas B Desai, Ritu Kashikar, Chandresh O. Karnawat and Shruti S. Rathod
Department of Radiology, Clinical Associate at Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India
*Corresponding author: Jyoti N, Department of Radiology, Clinical Associate at Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India. E-mail Id: jyoti119@gmail.com
Copyright: ©2025 Jyoti N, et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Article Information: Submission: 07/08/2025; Accepted: 29/09/2025; Published: 03/10/2025
Abstract
Crossed testicular ectopia (CTE) is an uncommon congenital anomaly where one testis migrates to the contralateral scrotum. It is often associated with genitourinary anomalies, particularly persistent Müllerian duct syndrome (PMDS). PMDS occurs due to defective anti-Müllerian hormone (AMH) secretion
or receptor response, leading to the persistence of Müllerian derivatives such as the uterus and fallopian tubes in phenotypic males. This association is observed in 20–30% of CTE cases and may be overlooked radiologically. Early diagnosis is crucial because both ectopic testes and Müllerian remnants are
predisposed to malignant transformation.
We present a case of a one-year-old male with unilateral scrotal swelling and an impalpable contralateral testis. MRI revealed bilateral testes on the same (right) side and an additional soft tissue suggestive of a Müllerian structure. Surgical exploration confirmed CTE with PMDS, and management involved orchidopexy with excision of Müllerian remnants.
This case underscores the importance of high-resolution imaging, particularly MRI, for accurate diagnosis of complex gonadal anomalies and highlights the need for early surgical intervention to prevent long-term complications such as malignancy and infertility.
We present a case of a one-year-old male with unilateral scrotal swelling and an impalpable contralateral testis. MRI revealed bilateral testes on the same (right) side and an additional soft tissue suggestive of a Müllerian structure. Surgical exploration confirmed CTE with PMDS, and management involved orchidopexy with excision of Müllerian remnants.
This case underscores the importance of high-resolution imaging, particularly MRI, for accurate diagnosis of complex gonadal anomalies and highlights the need for early surgical intervention to prevent long-term complications such as malignancy and infertility.
Keywords:Crossed testicular ectopia; Persistent Müllerian duct syndrome; Testicular ectopia; Müllerian remnants; Pediatric urology