Abstract Book - 26th ESPU Congress, Joint Meeting with ICCS + SPU + AAP/SOU + AAPU + SFU

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VR-7 (VS)
SPLENOGONADAL FUSION IN AN 18-MONTH-OLD BOY
Janae PREECE1, Stephen PHILLIPS 2, Victoria SOROKIN3, Karen DIEFENBACH4, Christina CHING1 and Daniel HERZ1
1) Nationwide Children's Hospital, Urology, Columbus, USA - 2) CAMC Health System, Urology, Charleston, USA - 3)
Nationwide Children's Hospital, Pathology and Laboratory Medicine, Columbus, USA - 4) Nationwide Children's Hospital,
Pediatric General Surgery, Columbus, USA
PURPOSE
Splenogonadal fusion is a rare congenital connection of the primitive spleen and gonad. Approximately 190 cases have
been described since being first publicized in 1883 by pathologist Eugen Bostroem. The fusion is attributed to the
development of the spleen in close proximity to the urogenital ridge and tracking of the splenic tissue as the testis
descends. It commonly presents as either cryptorchidism or a palpable mass. We present a case of splenogonadal
fusion and its management.
PATIENTS AND METHODS
An 18-month-old male presented to our urology office with a non-palpable right testicle and a retractile left testicle. His
treatment was recorded.
RESULTS
Laparoscopic examination (shown in our video) revealed a viable right testicle which was then brought into the right
hemiscrotum and a retractile left testicle with adherent abnormal tissue appearing consistent with discontinuous
splenogonadal fusion. Additional splenic tissue was found along the path of the testicular vessels. Options for further
management were discussed with the family. A nuclear medicine liver-spleen scan (shown) demonstrated uptake in the
area of the left gonad consistent with splenogonadal fusion. The patient’s parents then elected for excision of the
aberrant tissue adherent to the left testicle. Using an open inguinal approach, the splenic tissue was removed from the
testicle and an orchiopexy was performed as is seen in our video. Pathology, shown, confirmed the diagnosis.
CONCLUSIONS
Removal of the splenic component in splenogonadal fusion may be accomplished with preservation of the testicle, as in
our patient.