A Case Report – Characterization of Splenogonadal Fusion by Contrast-Enhanced Ultrasound (CEUS) and Elastography

Trottmann, M.; Marcon, Julian; Mai, V; D’Anastasi, Melvin; Becker, Andreas; Stief, Christian G.; Reiser, MF; Clevert, DA

doi:10.1055/s-0034-1369759

Cited by 10 publications

(12 citation statements)

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“…In elastography of splenogonadal fusion a higher stiffness compared to the adjacent tissue can be observed. CEUS reveals a characteristic arterial hypervascularization with contrast-pooling of the lesion in the late phase, similar to that of healthy splenic tissue [2].…”

Section: Discussionmentioning

confidence: 75%

“…Splenogonadal fusion is predominant in male patients with a ratio of circa 16:1 and can be classified into a continuous and discontinuous form. In cases of continuous splenogonadal fusion a splenic or fibrous cord between the spleen and the gonads can be found [2,7]. An association with other congenital malformations such as cryptorchidism, limb defects and micrognathia and in fewer cases also cardiac defects, spina bifida or cleft palate, was assessed in approximately 50% of all cases of continuous splenogonadal fusion.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, in most cases it can be found on the left side of the testis and is an important differential diagnosis to other scrotal masses, especially testicular cancer. In unclear cases splenogonadal fusion might cause un-necessary orchiectomies with benign pathologic results [1,2].…”

Section: Introductionmentioning

confidence: 99%

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

Grosu¹,

Rübenthaler²,

Knösel

et al. 2019

Med Ultrason

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We present the case of splenogonadal fusion in a 53-year-old male patient assessed by ultrasound and MRI, confirmed by pathologic examination. In addition to B-mode and colour-coded Doppler ultrasound, shear wave elastography and CEUS were performed and are presented in detail. Splenogonadal fusion is a rare congenital anomaly presumably caused by an abnormal attachment of splenic tissue to the gonad during gestation. Diagnosis is challenging for clinicians and in unclear cases splenogonadal fusion might cause unnecessary orchiectomies with benign pathologic results. Ultrasound is the first-line imaging modality in the diagnosis of testicular pathologies. This case report summarizes all available modern ultrasound imagingtechnologies and highlights the possibilities for the diagnosis of splenogonadal fusion.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

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

Grosu¹,

Rübenthaler²,

Knösel

et al. 2019

Med Ultrason

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show abstract

“…7 The CEUS appearances of SGF have also recently been described. 8 Similar to normal splenic and perisplenic accessory tissue, SGF showed homogenous arterial phase hyperenhancement and retained contrast in the delayed phase that was greater than the adjacent testicular tissue. Typically, malignant testicular and paratesticular lesions show more disorganised vascularity and would be expected to show washout of ultrasound contrast.…”

Section: Discussionmentioning

confidence: 85%

“…Given that SGF can be managed conservatively, a diagnosis before an orchidectomy should be aimed for, but this is challenging with intra-testicular SGF. If the suspicion of SGF is raised on the basis of sonographic features or recognised clinical associations, further characterisation with CEUS is encouraged and the options of a nuclear medicine study 9 or biopsy/intra-operative frozen section exist 8 to confirm the diagnosis and avoid excisional biopsy or orchidectomy.…”

Section: Discussionmentioning

confidence: 99%

Splenogonadal fusion: A rare paratesticular lesion and how to recognise it on ultrasound

et al. 2019

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Introduction Splenogonadal fusion is a rare developmental disorder that results in a gonadal or paragonadal mass due to the close proximity of the developing spleen and gonad. Case report We describe a case of splenogonadal fusion presenting as a paratesticular mass in a 25-year-old male. This was ultimately diagnosed on surgical biopsy. Discussion Splenogonadal fusion is a rare abnormality but can be managed conservatively. The sonographic features and the differential diagnosis are highlighted. Conclusion Through this case, we highlight the clinical and sonographic features of splenogonadal fusion. Awareness amongst ultrasound practitioners is important, given that it can be managed conservatively, and means of a non-invasive diagnosis are highlighted.

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A case of splenogonadal fusion in the left testis

zhou

2023

Clinical Case Reports

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Key Clinical MessageSplenic tissue outside the normal anatomical site can be collectively referred to as ectopic spleen. Clinically, the commonest causes of ectopic spleen include accessory spleen, splenic tissue implantation, and splenogonadal fusion (SGF). Accessory spleen is mostly caused by congenital dysplasia, is mostly located near the spleen, and may be supplied by the splenic artery. Splenic implantation is mostly caused by autologous spleen tissue transplantation caused by trauma or surgery. SGF is the abnormal fusion of the spleen with the gonad or with the mesonephric derivatives. As a rare developmental malformation, it is difficult to make a correct diagnosis preoperatively, and easily misdiagnosed as a testicular tumor cause lifelong harm to patients. An 18‐year‐old male student who developed left testicular pain without obvious cause that radiated to the perineum 4 months prior to presentation. He was diagnosed with cryptorchidism 12 years ago and underwent orchiopexy without intraoperative frozen section examination. An ultrasound was performed, identifying hypoechoic nodules in the left testis, suggestive of seminoma. During surgery, the testicular tumor revealed a dark red tissue and the diagnosis of a pathological ectopic splenic tissue was made. Because the clinical manifestations of SGF are not specific, misdiagnosis and unnecessary orchiectomy may occur. If a complete preoperative examination which includes biopsy or intraoperative frozen section is performed, unnecessary orchiectomy can be effectively avoided and bilateral fertility can be preserved.

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A Case Report – Characterization of Splenogonadal Fusion by Contrast-Enhanced Ultrasound (CEUS) and Elastography

Cited by 10 publications

References 0 publications

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

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

Splenogonadal fusion: A rare paratesticular lesion and how to recognise it on ultrasound

A case of splenogonadal fusion in the left testis

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