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Splenogonadal Fusion : Introduction & Clinical

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Introduction: Splenogonadal fusion (SGF) is a congenital anomaly in which splenic tissue is abnormally fused with the gonad (testis, epididymis, vas deferens, or ovary). It is more common in men (95% of cases) and is usually seen on the left side (>98% of cases). Majority of the patients (80%) present by 30 years of age; about 50% of cases are younger than 10 years.

Clinical Features: Most cases of SGF are discovered incidentally during inguinal hernia repair or during orchidopexy for cryptorchidism. Some cases present with scrotal or testicular swelling when the ectopic splenic tissue undergoes reactive hyperplasia secondary to an infection or inflammation. Such cases often mimic a primary testicular neoplasm and may result in unnecessary orchiectomy (as happened in this case). On testicular ultrasound, the ectopic splenic tissue appears as a homogenous, hypervascular, well-demarcated, encapsulated extratesticular mass that is isoechoic with the testis.

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