Sonographic findings in splenogonadal fusion

Cirillo, R; Coley, Brian D.; Binkovitz, Larry A.; Jayanthi, Rama

doi:10.1007/s002470050540

Cited by 36 publications

(26 citation statements)

References 2 publications

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“…However in presence of coexisting conditions, such as testicular torsion, cryptorchidism, malignancy, surgical treatment is warranted. [29][30] In our case, as there is high risk of malignancy in the intra-abdominal supernumerary testicle in future, so a decision of Orchiectomy taken along with orchidopexy and Dartos pouch for ipsilateral undescended testicle.…”

Section: Managementmentioning

confidence: 75%

A rare presentation: duplication of testis

Jatkar¹,

Deshpande²,

Madankar³

et al. 2014

Int Surg J

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Section: Managementmentioning

confidence: 75%

A rare presentation: duplication of testis

Jatkar¹,

Deshpande²,

Madankar³

et al. 2014

Int Surg J

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“…Though a sonogram would be in order for the workup of a testicular mass, a definite diagnosis cannot be made solely on the basis of sonographic findings. 5 Some authors have resorted to using 99Tc -Sulfur colloid imaging to identify ectopic splenic tissue. 6 An MRI scan is valuable as it gives the necessary soft tissue and vascular delineation.…”

Section: Discussionmentioning

confidence: 99%

Rare content in congenital inguinal hernia: splenogonadal fusion band

Babu

Kumar

2016

Int Surg J

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A 21 years old male attended our OPD with complaints of a left inguino -scrotal swelling. The swelling was reducible and was present since years of age. On initial examination the sac was felt along with the cord structures in the root of the scrotum. Both testes were descended and the external genetalia was normal. He was diagnosed to have left congenital hernia and underwent elective inguinal exploration. The sac was identified, separated from cord structures and opened. An elongated, purplish-red, fleshy band of tissue was found inside the sac, adherent to the upper pole of testis. Further exploration through the internal ring revealed this tissue was found extending towards the left upper quadrant of the abdomen, trans-peritoneally. Some large vessels were seen on the surface of the band. Gross anatomy of testis appears to be normal. A provisional diagnosis of splenogonadal fusion was made. However, as the relative contribution of the vessels from the band to the vascularity of the testis could not be determined and a pre-operative consent for orchidectomy was not available, it was decided to take a biopsy from this tissue. A vascular clamp was made on the band and viability of testis is ascertained. Band in the inguinal canal was sewen at deep ring and at upper pole of testis and the band in between them was taken for biopsy. A diagnostic laparoscopy was done in the same setting via an open umbilical approach. Complete abdominal exploration showed a vascular connective band coming out of the left internal inguinal ring and directed towards the spleen. Macroscopic appearance showed the surgical specimen (4x2 cms) to be parenchymatous, with histopathological examination demonstrating the presence of splenic tissue, including red pulp and sinusoids confirming the diagnosis of left continuous splenogonadal fusion. The postoperative course was uneventful and the patient was discharged two days post operation. DISCUSSIONSpleno-gonadal fusion is a rare congenital malformation in which the spleen is abnormally connected to the gonads or rarely to the mesonephric structures like vas or epididymis.1 More than 150 cases have been described in world literature so far. Putschar & Manion classified splenogonadal fusion into two types, viz. continuous and discontinuous.2 In the continuous variant, the spleen is connected to the gonads by a fibrous cord, a splenic cord or a beaded cord of mixed fibrous and splenic tissue. In ABSTRACT 21 years old male underwent elective inguinal exploration for left congenital hernia. Per-operatively, an elongated, purplish-red, fleshy and beaded band of tissue was found inside the sac, adherent to the upper pole of testis. Biopsy was taken and the wound closed. A diagnostic laparoscopy was done in the same setting to visualize the origin of the band proved it to be from spleen. The histo-pathology of the specimen was reported as normal splenic tissue. The above features are consistent with a diagnosis of spleno -gonadal fusion (SGF) (splenic anomaly).

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“…The diagnosis is usually made on the operating table during surgery for hernia, undescended testis or testicular mass. Though a sonogram would be in order for the workup of a testicular mass, a definite diagnosis cannot be made solely on the basis of sonographic findings [6]. Some authors have resorted to using 99Tc -Sulfur colloid imaging to identify ectopic splenic tissue [7].…”

Section: Discussionmentioning

confidence: 99%

“…Orchiectomy should be avoided for these benign lesions. Unfortunately, 37% of the reported cases are associated with orchiectomy [6].…”

Section: Discussionmentioning

confidence: 99%

An Unusual Content in a Congenital Hernia - Complete Spleno –gonadal Fusion Band

Mahalakshmi

Barathi

2012

Indian J Surg

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Six years old boy underwent elective inguinal exploration for left congenital hernia. Per-operatively, an elongated, purplish-red, fleshy band of tissue was found inside the sac, adherent to the upper pole of testis. Biopsy was taken and the wound closed. An MRI done after 4 weeks proved the origin of the band from spleen. Laparotomy and excision of the band was done. The histo-pathology of the specimen was reported as normal splenic tissue. The above features are consistent with a diagnosis of spleno -gonadal fusion (SGF).Keywords Spleno-gonadal fusion . MRI for spleno-gonadal fusion . Splenic tissue in the testis . Splenic anomalies Case ReportA 6 years old boy attended our OPD with complaints of a left inguino -scrotal swelling. The swelling was reducible and was present since 1 1/2 years of age. On initial examination the sac was felt along with the cord structures in the root of the scrotum. Both testes were descended and the external genetalia was normal. He was diagnosed to have left congenital hernia and underwent elective inguinal exploration. The sac was identified, separated from cord structures and opened. An elongated, purplish-red, fleshy band of tissue was found inside the sac, adherent to the upper pole of testis (Fig. 1). Further exploration through the internal ring revealed this tissue was found extending towards the left upper quadrant of the abdomen, trans-peritoneally. Some large vessels were seen on the surface of the band. A provisional diagnosis of spleno gonadal fusion was made. However, as the relative contribution of the vessels from the band to the vascularity of the testis could not be determined and a pre-operative consent for orchiectomy was not available, it was decided to takea biopsy from this tissue. A wedge biopsy was taken and the wound was closed. The histo-pathology of the biopsy specimen was reported as normal splenic tissue.An MRI scan was done (4 weeks after the initial surgery) to delineate the soft tissue & vascular anatomy. A long cord-like extension of splenic tissue was seen from the inferior pole of the spleen to the level of the left inguinal canal (Fig. 2). It was located just deep to the parietal wall and was anterior to the descending colon and the left ilio-psoas. The signal intensity of this cord of tissue was seen paralleling the spleen in all sequences. A thin vascular channel could also be traced from the splenic hilum into the cord of tissue, further confirming its origin from the spleen. The left testis was small in size and was closely apposed to the inferior end of this cord of splenic tissue at the level of the inguinal canal. The above features were consistent with a diagnosis of complete spleno-gonadal fusion (SGF). A dopplerultrasonogram was also done which showed the presence of good, independent vascular supply to the testis via the vessels in the cord structures.A mini -laparotomy and left inguinal exploration was carried out. The band was found arising from the inferior

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Sonographic findings in splenogonadal fusion

Abstract: Splenogonadal fusion is a rare developmental anomaly usually presenting as a scrotal mass. The imaging findings and etiology of this condition are discussed. Knowledge of this entity may help to prevent unnecessary orchiectomy.

Cited by 36 publications

References 2 publications

A rare presentation: duplication of testis

A rare presentation: duplication of testis

Rare content in congenital inguinal hernia: splenogonadal fusion band

An Unusual Content in a Congenital Hernia - Complete Spleno –gonadal Fusion Band

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