Hepatogonadal fusion

Abstract

Fusion of the testis with adrenal remnants is a relatively common incidental finding during orchidopexy. Splenogonadal fusion has been described in several cases. Herein the authors report a case of hepatogonadal fusion. To their knowledge, this is the first such case in the literature. Ectopic liver tissue has been encountered in a variety of locations, but had not been found in a testicle. The trapping of hepatocyte-destined mesenchyma in different areas may explain the presence of heterotopic liver tissue in different organs. If these cell aggregates are trapped in the area of peritoneum where the testis is forming, heterotopic liver tissue can end up in the testis.

Hepatogonadal fusion

“…A significant number of rare splenogonadal fusions cases have also been reported [1]. However, hepatogonadal fusion is extremely rare because there are only 2 previous cases in the English literature [2,3]. We report the third case with unique features that are different from the previously reported cases.…”

“…In the first reported case, the liver tissue could only be identified at the upper pole of right testicle, although a fibrous-like pedicle was followed all the way to the porta hepatis [3]. In the second reported case, there was a reversed situation in which immature testis tissue was found adherent to the right lobe of liver after tracing testicular vessels from right gubernaculum at the internal ring [2].…”

Ectopic Liver in Gall Bladder : A Case Report

“…This hepatic diverticulum extends into the septum transversum, where it enlarges and divides into two parts: the larger cranial portion (Pans hepatica), which further divides to form the liver cells and intrahepatic biliary apparatus of the right and left hepatic lobes, and the smaller caudal portion (Pars cystica), which gives rise to the gallbladder and the cystic duct. 5 Several theories have been proposed to explain the development of ectopic liver at different sites: development of an accessory lobe of the liver with atrophy or regression of the original connection to the main liver, 4 migration or displacement of a portion of the cranial part (Pars hepatica) of the liver bud to other sites, 6 dorsal budding of hepatic tissue before the closing of the pleuroperitoneal canal (may explain how EL develops in the thoracic cavity such as esophagus, pericardium, intra pleural or extra pleural), 7 trapping of hepatocyte-destined mesenchyma in different areas 8 and entrapment of nests of cells in the region of the foregut following closure of the diaphragm or umbilical ring. 9 The close relationship of the developing hepatic parenchyma cell cords to the pars cystica and early fetal duodenum may explain why ectopic hepatic tissue could be found in the wall of the gallbladder, the gastrohepatic ligament, the umbilical cord, the adrenal glands, the diaphragm, the pancreas, the pylorus, and the splenic capsule if a portion of the pars hepatica is displaced.…”

Pathology of the Pediatric Regio Inguinalis: Mysteries of the Hernia Sac Exposed

“…Often the ipsilateral kidney is absent. An exceptional case of hepatogonadal fusion found at right herniorrhaphy in an infant boy has been reported [40].…”