[Spleno-gonadal fusion. Apropos of 3 case reports]

Abstract

Splenogonadal fusion is a very rare congenital anomaly, usually diagnosed during operation for other surgical conditions as inguinal during operation for other surgical conditions as inguinal hernia, testicular tumor, cryptorchism or epididymitis and discontinuous. In first form exists a link of splenic and connective-fibrous tissue between spleen and testicle. This string runs above the bowels, then through an inguinal canal and joins the testicle or surrounds the gonad. Surgical treatment consists of cutting of the cord from spleen and separating from albugineals coat of testicle. In discontinuous form numerous tubercles of splenic tissue situated near gonad are confirmed. Three own cases are presented. First case concerns a 4 year-old boy with diagnosis: tumor of testicle and left inguinal hernia. Splenic tissue surrounded testicle and separated it from epididymis. An attempt of separation of these masses from the testicle was unsuccessful and hemicastration was performed and removed 17 cm long cord attached to the spleen. There was no union between testicle and epididymis on micro- and macroscopic examination. Second case refers to a 8 year-old boy with left-sides cryptorchidism. During an operation 7 cm long string like rosary was removed. Last case: 12 year-old boy was treated with diagnosis of tumor of spermatic cord and suspicion of spleno-gonadal fusion. A 15 cm long string connecting upper pole of testicle and spleen was amputated. The embryology, the diagnosis and the treatment are discussed in both cases.