Splenogonadal Fusion: Pathogenesis, Diagnosis and Management | Chapter 3 | Medical Research and Its Applications Vol. 10

 

Splenogonadal fusion is an abnormal connection between the spleen and gonads. This rare entity can be easily confused with testicular tumors. It usually accompanies congenital malformations, such as cryptorchidism, making diagnosis more difficult. Herein, we report two rare cases of this challenging diagnosis. The first case involved a 5-year-old child admitted for management of bilateral testicular cryptorchidism complicated by an inguinal hernia on the left. Intraoperatively, we discover a globular left testis with two red ovoid formations of 4mm. There was no connection between the testis and the lower edge of the spleen. One of these formations was biopsied, showing normal splenic parenchyma and confirming the diagnosis of splenogonadal fusion. The second case was a 9-month-old infant followed for a disorder of sex differentiation, stage III of Prader with a 46, XY genotype. Diagnostic laparoscopy showed bilateral testicular cryptorchidism with intraabdominal testes. There was a left testicular nodule connected to the lower cryptorchidism edge of the spleen with a cord-like structure. A biopsy of the nodule showed normal splenic parenchyma. Bilateral orchidopexy was performed without removal of the left testicular nodule. Our two cases highlight the fact that surgeons must be aware of this entity to avoid unnecessary orchiectomy. In some cases, a biopsy may help with diagnosis.

 

 

Author(s) Details

Khouloud Ben Lazreg

Pathology Department, Habib Thameur Hospital, Tunis, Tunisia.

Imen Helal

Pathology Department, Habib Thameur Hospital, Tunis, Tunisia and Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

Fatma Khanchel

Pathology Department, Habib Thameur Hospital, Tunis, Tunisia and Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

Aida Daieb

Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia and Pediatric Surgery Department, Habib Thameur Hospital, Tunis, Tunisia.

Sameh Tlili

Pediatric Surgery Department, Regional Hospital of Zaghouan, Zaghouan, Tunisia.

Sirine El Fekih

Pathology Department, Habib Thameur Hospital, Tunis, Tunisia and Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

Ehsen Ben Brahim

Pathology Department, Habib Thameur Hospital, Tunis, Tunisia and Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

Youssef Hellal

Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia and Pediatric Surgery Department, Habib Thameur Hospital, Tunis, Tunisia.

Raja Jouini

Pathology Department, Habib Thameur Hospital, Tunis, Tunisia and Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

Achraf Chadli Debbiche

Pathology Department, Habib Thameur Hospital, Tunis, Tunisia and Faculty of Medicine of Tunis, University of Tunis El Manar, Tunis, Tunisia.

 

Please see the link:- https://doi.org/10.9734/bpi/mria/v10/1124

Epidermoid Cyst of the Testis: Unveiling a Rare and Uncommon Diagnosis | Chapter 12| Medicine and Medical Research: New Perspectives Vol. 8

Epidermoid cysts of the testis are rare benign tumors that often pose a diagnostic challenge due to their clinical and radiological resemblance to malignant testicular masses. Accurate differentiation is crucial to avoid unnecessary radical surgical interventions. The case of a 27-year-old male who presented with dull pain and progressive enlargement of the left testicle over several months has been reported. Physical examination revealed an enlarged, dense, and irregular left testicle, with no history of trauma or inflammation. Scrotal ultrasonography identified a heterogeneous mass measuring 25 x 17 x 18 mm with minimal vascularization. Laboratory tests, including AFP, B-HCG, and LDH, were within normal limits. Imaging with a chest, abdominal, and pelvic CT scan showed no signs of metastatic disease. The patient underwent a left-sided radical orchiectomy, during which a 7-8 mm lymph node was excised from the inguinal canal. Histopathological examination confirmed the diagnosis of an epidermoid cyst, characterized by a cystic structure lined with stratified squamous epithelium filled with keratinous material. This case highlights the importance of early and accurate diagnosis in distinguishing epidermoid cysts from malignant testicular tumors, enabling organ-sparing surgery when appropriate. The report underscores the need for further studies to enhance the characterization and differentiation of these rare entities.

 

Author (s) Details

 

Vladimer Papava

Department of Urology, Tbilisi State Medical University, Georgia

 

Giorgi Sinauridze
Department of Urology, Tbilisi State Medical University, Georgia.

 

Valeriane Kvakhajelidze
Pineo Clinic, Georgia.

 

Andro Dzneladze
Pineo Clinic, Georgia.

 

Irakli Gakhokidze
Department of Radiology, Aversi Clinic, Georgia.

 

Leli Shanidze
Department of Laboratory, Tbilisi State Medical University, Georgia.

 

Levani Donadze
Pineo Clinic, Georgia.

 

Tamar Didbaridze
Department of Microbiology, Tbilisi State Medical University, Georgia.

 

Tamta Mamasakhlisi
Department of Internal Medicine, N. Kipshidze Central University Clinic of Tbilisi State Medical University (Former Republican Hospital), Georgia.

 

Ema Gergedava
Gidmedi Clinic, Georgia.

 

Otar Goguadze
Pineo Clinic, Georgia.

 

 

Please see the book here:- https://doi.org/10.9734/bpi/mmrnp/v8/2328