Splenogondal Fusion With Accessory Spleens Identified With Laparoscopy.

Emily Biben,Jeff Pugach

doi:10.7759/cureus.9017

Abstract

Splenogonadal fusion (SGF) is a congenital abnormality characterized by fusion between the spleen and gonad. This rare condition is difficult to diagnose preoperatively, and there are fewer than 200 cases documented previously in the literature. This report describes a young male who presented with bilateral cryptorchidism and was diagnosed with SGF and accessory spleens using laparoscopy. SGF is a rare but possible finding to recognize in children with abnormal paratesticular masses, and laparoscopic techniques as demonstrated in this case will increase the ease of diagnosis and early treatment.

Highlights

Splenogonadal fusion (SGF) is a congenital malformation with fewer than 200 cases documented in the literature since first described by Bostroem in 1883 [1,2]
We present a patient with discontinuous SGF and numerous accessory spleens to raise awareness of the rare but possible findings when encountering abnormal paratesticular masses in children
SGF remains of unknown etiology and results in the abnormal association of the spleen and gonad

Summary

Introduction

Splenogonadal fusion (SGF) is a congenital malformation with fewer than 200 cases documented in the literature since first described by Bostroem in 1883 [1,2]. We present a patient with discontinuous SGF and numerous accessory spleens to raise awareness of the rare but possible findings when encountering abnormal paratesticular masses in children. The patient’s subsequent chromosome analysis showed a normal 46,XY karyotype. At this time, the patient exhibited no additional physical or developmental abnormalities, and further genetic testing was deemed unnecessary. Diagnostic laparoscopy at five months of age revealed the left testis with an associated accessory spleen away from the internal ring (Figure 1), splenules tracking up the left colic gutter (Figure 2), and a separated epididymis. Frozen section confirmed gonadal fusion of an accessory spleen with normal splenic tissue, a rudimentary epididymis, and germ cells within the seminiferous tubules.

Discussion

Conclusions

Findings

Disclosures

Carragher AM