The unilateral enlargement of a testis, in the absence of symptoms that point towards an acute scrotum, is a situation that must require careful assessment because the exclusion of a tumour process is the first step to be taken. Tumour or endocrine disorders, such as hypothyroidism and the adrenal genital syndrome, must necessarily enter into differential diagnosis. Unilateral cause of unilateral enlargement of the testis is the benign monolateral macrorchidism. This little known condition can also occur in childhood or early adolescence. Unilateral magnification is not necessarily an indication for surgical exploration if there are no clinical signs, tumour markers and suspect images. The described case of macroorchdism in a 9-year-old child belongs to the benign forms, as a compensatory framework to a gonadal suffering of the contralateral testis.
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