Splenogonadal fusion evaluation using Contrast Enhanced Ultrasound and Elastography. A case report.

Grosu, Sergio; Rübenthaler, Johannes; Knösel, Thomas; Trottmann, Matthias; Marcon, Julian; Clevert, D.‐A.

doi:10.11152/mu-1897

Cited by 4 publications

(2 citation statements)

References 10 publications

(13 reference statements)

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“…In contrast, the non-continuous type usually presents as a low-reflectivity mass and may contain multiple small hypoechoic nodules, which may be associated with peak development of the lymphatic system and splenic white marrow in younger children; as a result, it has a higher diagnostic value in children aged 1–5 years who develop this condition ( 21 ). High vascular density in color Doppler flow imaging (CDFI) is helpful in the differential diagnosis of malignant tumors, and contrast-enhanced ultrasonography is also valuable in identifying benign and malignant testicular tumors ( 19 ). CT and MRI have high diagnostic value for continuous splenogonadal fusion.…”

Section: Discussionmentioning

confidence: 99%

Splenogonadal fusion: a case report of three cases and a literature review

Luo,

Xu,

Wang

et al. 2024

Front. Pediatr.

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PurposeThis 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.MethodsWe 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.ResultsAfter 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.ConclusionIt 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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Section: Discussionmentioning

confidence: 99%

Splenogonadal fusion: a case report of three cases and a literature review

Luo,

Xu,

Wang

et al. 2024

Front. Pediatr.

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“…Our present case of left SGF in a male infant presented with bilateral cryptorchidism was not unusual for known SGF cases (Table 1) [3,5,12]. We used ultrasound to reach a preliminary diagnosis that was further confirmed by laparoscopy, this diagnostic process was also used in f follow-up ultrasound 1 year after the surgery showed that the left and right testes had a size of 1.0 × 0.6 × 0.6 cm and 1.3 × 0.7 × 0.7 cm, respectively, both with a homogeneous echogenic appearance and normal blood supply other reported SGF cases [12,13,20,38]. What made our case unusual was that due to high positions of both testes (in the abdominal cavity), fusion of the left testis to the spleen and the poorly developed and short right spermatic vessel, it would be very difficult and risky to perform routine single stage orchiopexy on either side.…”

Section: Discussionmentioning

confidence: 99%

Splenogonadal fusion: a case report and review of the literature

et al. 2021

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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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