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Luo N, Xu Q, Wang H, Su J, Li S. Splenogonadal fusion: a case report of three cases and a literature review. Front Pediatr 2024; 11:1269879. [PMID: 38239597 PMCID: PMC10794592 DOI: 10.3389/fped.2023.1269879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Accepted: 12/07/2023] [Indexed: 01/22/2024] Open
Abstract
Purpose This case report aims to enhance the understanding of clinical physicians regarding splenogonadal fusion (SGF) and to help them consider SGF as a differential diagnosis when testicular tumors are suspected, thus avoiding unnecessary orchiectomies. Methods We report three cases of SGF admitted to our hospital, one of which presented as a suspected testicular tumor. We also searched the literature on scrotal masses from the last 25 years and summarize the characteristics of cases of SGF manifesting as scrotal swelling combined with our cases. Results After conducting a thorough search, we found a total of 24 publications relevant to this case study, which included 25 testes. All lesions were located on the left side, and the average age of those affected was 20.22 years. Seven cases were of the continuous type. Three cases presented with pain, all of which were intratesticular masses. Thirty cases had a definite onset duration, ranging from 3 weeks to 10 years. Nine patients (36%) underwent orchiectomy, and one underwent partial orchiectomy. Conclusion It is crucial to identify SGF in the clinic. When a patient presents with scrotal swelling, diagnosing SGF preoperatively is challenging, and it should be considered when there is a long history of a stable testicular mass. An intraoperative frozen section should be performed if a testicular tumor is suspected to avoid unnecessary orchiectomy.
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Affiliation(s)
- Na Luo
- Department of Radiology, Shenzhen Children’s Hospital, Shenzhen, China
| | - Qitao Xu
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children’s Hospital, Shenzhen, China
| | - Hao Wang
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children’s Hospital, Shenzhen, China
| | - Jiahong Su
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children’s Hospital, Shenzhen, China
| | - Shoulin Li
- Department of Urology and Laboratory of Pelvic Floor Muscle Function, Shenzhen Children’s Hospital, Shenzhen, China
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Alkukhun L, Ionno A, Stanton M, Serinelli S, Baker R, Hanumaiah R, Majmudar A. Splenogonadal fusion presenting as a testicular mass, a case report and literature review. Radiol Case Rep 2022; 17:2191-2194. [PMID: 35496753 PMCID: PMC9048054 DOI: 10.1016/j.radcr.2022.01.065] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 01/22/2022] [Indexed: 11/17/2022] Open
Affiliation(s)
- Leen Alkukhun
- Department of Radiology, SUNY Upstate Medical University, Rm. 3428, 750 East Adams Street, Syracuse, NY 13210, USA
- Corresponding author. L. Alkukhun.
| | - Alyssa Ionno
- Department of Radiology, SUNY Upstate Medical University, Rm. 3428, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Meghan Stanton
- Department of Radiology, SUNY Upstate Medical University, Rm. 3428, 750 East Adams Street, Syracuse, NY 13210, USA
| | | | - Ryan Baker
- Department of Radiology, SUNY Upstate Medical University, Rm. 3428, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Ravikumar Hanumaiah
- Department of Radiology, SUNY Upstate Medical University, Rm. 3428, 750 East Adams Street, Syracuse, NY 13210, USA
| | - Anand Majmudar
- Department of Radiology, SUNY Upstate Medical University, Rm. 3428, 750 East Adams Street, Syracuse, NY 13210, USA
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Chen G, Wang X, Zhao Y, Zhu L, Tang D. Splenogonadal fusion: a case report and review of the literature. BMC Urol 2021; 21:16. [PMID: 33536002 PMCID: PMC7860507 DOI: 10.1186/s12894-021-00781-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 01/07/2021] [Indexed: 11/28/2022] Open
Abstract
Background Splenogondal fusion (SGF) is a rare congenital anomaly characterized by abnormal association between the splenic tissue and the gonads or mesonephric remnants. SGF that requires separate two-stage laparoscopic staged Fowler-Stephen orchiopexy on both the left and right sides is extremely rare. SGF could be misdiagnosed as testicular malignancy and leads to unnecessary orchiectomy. Case presentation This is a case of an 8-month old male infant presented with bilateral cryptorchidism, B-mode ultrasound visualized the left and right testes in the lower abdominal cavity and the upper margin of the left testicle as a hypoechoic mass extending to the spleen, indicating an undescended right testis and possible SGF on the left side. Single-site laparoscopic examination confirmed the diagnosis of SGF on the left side and an undescended right testis. As both testes were high and the right spermatic vessel was poorly developed and short, a routine single stage orchiopexy would be difficult and risky, therefore, separate two-stage laparoscopic staged Fowler-Stephen orchiopexies for both sides were implemented. Stage 1 of the staged Fowler-Stephen orchiopexy for the right side was performed first without treating the left side, Stage 2 for the right side, separation of the left testis from the spleen as well as Stage 1 for the left side were performed 7 months later, and Stage 2 for the left side was performed 7 months after that. Follow-up ultrasound 1 year after the surgery revealed no obvious abnormalities in the shapes of the testes or their blood supply. This treatment strategy prevented unnecessary orchiectomy. Conclusions We reported a rare case of SGF that needed separate two-stage laparoscopic staged Fowler-Stephen orchiopexies for both sides, and a review of the recent literature. SGF is a rare congenital anomaly often diagnosed incidentally during exploration/surgery for scrotal swelling/mass, cryptorchidism or inguinal hernia in young patients. Surgeons, especially pediatric surgeons should be aware of this rare condition to avoid unnecessary, life-altering radical orchiectomy. When routine single stage orchiopexy is not feasible or risky for either side, separate two-stage laparoscopic staged Fowler-Stephen orchiopexies could be performed on both the left and right sides to avoid unnecessary orchiectomy.
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Affiliation(s)
- Guangjie Chen
- Department of Urology, The Children's Hospital, Zhejiang University, School of Medicine, National Clinical Research Center for Child Health, 57 Zhugan Xiang, Hangzhou, 310053, China
| | - Xiaohao Wang
- Department of Urology, The Children's Hospital, Zhejiang University, School of Medicine, National Clinical Research Center for Child Health, 57 Zhugan Xiang, Hangzhou, 310053, China
| | - Yijun Zhao
- Department of Urology, The Children's Hospital, Zhejiang University, School of Medicine, National Clinical Research Center for Child Health, 57 Zhugan Xiang, Hangzhou, 310053, China
| | - Linfeng Zhu
- Department of Urology, The Children's Hospital, Zhejiang University, School of Medicine, National Clinical Research Center for Child Health, 57 Zhugan Xiang, Hangzhou, 310053, China
| | - Daxing Tang
- Department of Urology, The Children's Hospital, Zhejiang University, School of Medicine, National Clinical Research Center for Child Health, 57 Zhugan Xiang, Hangzhou, 310053, China.
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Alsunbul A, Alsuhaibani S, Al Ali H, Alhussain T, Aldawsari N, Alhathal N. Splenogonadal fusion: A rare case report and literature review. Urol Case Rep 2020; 33:101307. [PMID: 33102010 PMCID: PMC7573839 DOI: 10.1016/j.eucr.2020.101307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 06/15/2020] [Accepted: 06/17/2020] [Indexed: 10/25/2022] Open
Abstract
Splenogonadal fusion is a rare benign congenital anomaly with few cases described in the literature. It is 16 times more common in males than in females. A 22 year-old healthy male with cryptorchidism presented with preoperative imaging strongly suggestive of malignancy. Histopathology after left orchiectomy showed mixed splenic and testicular tissue with no sign of malignancy. Splenogonadal fusion is rarely diagnosed preoperatively. It should be included in differential diagnoses in patients presenting with a testicular or abdominal mass. Greater recognition of this rare anomaly may facilitate testis sparing surgery in future cases.
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Affiliation(s)
- Abdulrahman Alsunbul
- King Faisal Specialist Hospital, Urology Department, Riyadh, Saudi Arabia.,Prince Sultan Military Medical City, Urology Department, Riyadh, Saudi Arabia
| | | | - Hamed Al Ali
- King Faisal Specialist Hospital, Urology Department, Riyadh, Saudi Arabia
| | - Turki Alhussain
- King Faisal Specialist Hospital, Pathology Department, Riyadh, Saudi Arabia
| | - Nasser Aldawsari
- King Faisal Specialist Hospital, Pathology Department, Riyadh, Saudi Arabia
| | - Naif Alhathal
- King Faisal Specialist Hospital, Urology Department, Riyadh, Saudi Arabia
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Mann JA, Ritchie E. Splenogonadal fusion: A case of two lesions. Urol Case Rep 2019; 24:100878. [PMID: 31211087 PMCID: PMC6562919 DOI: 10.1016/j.eucr.2019.100878] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2019] [Revised: 03/18/2019] [Accepted: 03/20/2019] [Indexed: 11/26/2022] Open
Abstract
Splenogonadal fusion is a rare congenital anomaly that presents as a testicular mass and is clinically difficult to distinguish from primary malignancy. It is a benign condition which commonly results in a radical orchidectomy. This case report describes a 22-year-old male with a new multi-focal lesion discovered on self-examination. It aims to provide additional information in hopes of supporting other surgeons to diagnose this condition and prevent unnecessary radical orchidectomy.
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Affiliation(s)
- Jordan A Mann
- Department of Urology, Tauranga Public Hospital, 829 Cameron Rd, Tauranga South, Tauranga, 3112, New Zealand
| | - Ezra Ritchie
- Department of Urology, Tauranga Public Hospital, 829 Cameron Rd, Tauranga South, Tauranga, 3112, New Zealand
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Shakeri A, Shakeri A, Rasolmali R, Shakeri S. A case of splenogonadal fusion accompanied by accessory spleen in a 4-year-old boy. Urol Ann 2018; 10:406-408. [PMID: 30386095 PMCID: PMC6194785 DOI: 10.4103/ua.ua_194_17] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Splenogonadal fusion (SGF) is a rare benign malformation in which spleen is aberrantly attached to the gonads or mesonephric derivatives. This entity often presents with scrotal mass, inguinal hernia, or cryptorchidism. Herein, we report our experience with a boy who presented with a scrotal enlargement which later turned out to be SGF. Moreover, an accessory spleen was unexpectedly found in the left inguinal canal. To the best of our knowledge, this is the first report of SGF and accessory spleen in the literature. Although rare, SGF should be included in the complete differential diagnosis list of scrotal masses, especially in children. The use of frozen section pathology if available would aid the surgeon in avoiding unnecessary orchiectomy in small testicular masses of benign origin.
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Affiliation(s)
- Aria Shakeri
- University of Virginia School of Medicine, Charlottesville, USA
| | - Arash Shakeri
- School of Pharmacy, Health Sciences Campus, University of Waterloo, Waterloo, Canada
| | - Reza Rasolmali
- Department of Pathology, Shiraz Central Hospital, Shiraz, Iran
| | - Saeed Shakeri
- Shiraz Nephro-Urology Research Center, Department of Urology, Shiraz University of Medical Sciences, Shiraz, Iran
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