Department of Urology, The Third Medical Center of Chinese PLA General Hospital, 69 Yong Ding Rd, Beijing, 100039, China.
Department of Urology, State Key Laboratory of Kidney Diseases, Chinese PLA General Hospital/PLA Medical School, Beijing, 100853, China.
Diagn Pathol. 2023 Mar 30;18(1):42. doi: 10.1186/s13000-023-01332-w.
Splenogonadal fusion (SGF) is a rare congenital malformation in which the spleen is abnormally connected to the gonads or to the mesonephric derivatives. There is no obvious causality between SGF and testicular neoplasm. However, cryptorchidism, which is a well-known risk factor of testicular germ cell tumors, are the most frequent malformations associated with SGF. To our knowledge, there are only four reported cases of SGF associated with testicular neoplasm so far. Herein, we reported a patient of this condition, and briefly reviewed the related literature.
A 48-year-old man was diagnosed with bilateral cryptorchidism 30 years prior, and only underwent a right orchiopexy for the left testicle could not be explored during the operation. At that time, doctors failed to realize the possibility of SGF due to the lack of sufficient knowledge of this condition. This time, the patient was treated for a left abdomen mass that was diagnosed as stage III metastatic seminoma. Then, a right orchiectomy, robot-assisted laparoscopic left retroperitoneal tumor resection, and left retroperitoneal lymph node dissection was performed after four cycles of BEP (bleomycin + etoposide + cisplatin) systemic chemotherapy in our center. The final diagnosis of SGF was made by postoperative pathology. The patient was re-examined in our center at 3 months and 6 months after the operation, and no obvious abnormalities were found.
Surgeons should always bear in mind the possibility of association between bilateral cryptorchidism and splenogonadal fusion to avoid malignant transformation caused by delayed treatment.
脾性腺融合（SGF）是一种罕见的先天性畸形，脾异常连接到性腺或中肾衍生物。SGF 与睾丸肿瘤之间没有明显的因果关系。然而，隐睾症是睾丸生殖细胞肿瘤的一个众所周知的危险因素，是最常与 SGF 相关的畸形。据我们所知，迄今为止，只有 4 例与睾丸肿瘤相关的 SGF 病例报告。在此，我们报告了一例这种情况，并简要回顾了相关文献。
一名 48 岁男性，30 年前被诊断为双侧隐睾症，由于当时缺乏对该病的充分认识，仅对右侧睾丸进行了睾丸下降固定术，左侧睾丸未能探查。此次，因左侧腹部肿块就诊，诊断为 III 期转移性精原细胞瘤。随后，在我院接受了 4 周期 BEP（博来霉素+依托泊苷+顺铂）全身化疗后，进行了右侧睾丸切除术、机器人辅助腹腔镜下左侧腹膜后肿瘤切除术和左侧腹膜后淋巴结清扫术。术后病理诊断为 SGF。术后 3 个月和 6 个月在我院复查，未见明显异常。
外科医生应始终牢记双侧隐睾症与脾性腺融合之间存在关联的可能性，以避免因治疗延误而导致恶性转化。
