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脾性腺融合:一例罕见病例报告及文献综述。

Splenogonadal fusion: A rare case report and literature review.

作者信息

Salehi Mahsa, Abedian Kenari Fatemeh, Ghasemi Maryam, Rehman Shafi, Salehi Mehrnaz, Jafari Hamid Reza

机构信息

Mazandaran University of Medical Sciences, Mazandaran, Iran.

Mazandaran University of Medical Sciences, Mazandaran, Iran.

出版信息

Int J Surg Case Rep. 2023 Aug;109:108480. doi: 10.1016/j.ijscr.2023.108480. Epub 2023 Jul 7.

Abstract

INTRODUCTION AND IMPORTANCE

Splenogonadal fusion is a rare congenital anomaly occurs when splenic tissue presents near or within a gonad. It mostly involves male children. Although it is benign and rare, making a pre-operation precise diagnosis is challenging which can lead to unnecessary invasive treatments.

CASE PRESENTATION

A 3-year-old boy was presented by the chief complaint of a painless mass on the left testis and left inguinal hernia. He had a previous history of bilateral cryptorchidism and orchiopexy. Ultrasonography showed a small mass on the inferior pole of left testis and left reducible inguinal hernia. He went under left orchiectomy and hernia repair. Pathological investigation of the specimen resembled normal splenic tissue next to testicular tissue and the diagnosis of splenogonadal fusion was made.

CLINICAL DISCUSSION

Splenogodal fusion cases can be challenging. Pain and sensation of mass in the scrotal sac are the most common presentation of splenogonadal fusion. Testicular malignancies can be considered as their main differential diagnosis, despite the fact that imaging and intra-operation frozen section can be helpful in making a definite diagnosis in some cases. It is mostly diagnosed incidentally during other procedures such as hernia repair or orchiopexy. Since it is benign, removal of tumor without orchiectomy is curative.

CONCLUSION

In dealing with testicular mass in children, raising awareness of splenogonadal fusion have utmost importance to prevent unnecessary radical surgical interventions.

摘要

引言与重要性

脾性腺融合是一种罕见的先天性异常,表现为脾脏组织出现在性腺附近或内部。它主要累及男童。尽管这种情况良性且罕见,但术前做出精确诊断具有挑战性,可能导致不必要的侵入性治疗。

病例介绍

一名3岁男孩因左侧睾丸无痛性肿块和左侧腹股沟疝为主诉前来就诊。他既往有双侧隐睾及睾丸固定术病史。超声检查显示左侧睾丸下极有一个小肿块以及左侧可复性腹股沟疝。他接受了左侧睾丸切除术和疝修补术。对标本的病理检查显示,在睾丸组织旁有类似正常脾脏组织的结构,从而诊断为脾性腺融合。

临床讨论

脾性腺融合病例具有挑战性。阴囊内疼痛和肿块感是脾性腺融合最常见的表现。尽管在某些情况下,影像学检查和术中冰冻切片有助于做出明确诊断,但睾丸恶性肿瘤仍可被视为其主要鉴别诊断。它大多在诸如疝修补术或睾丸固定术等其他手术过程中偶然被诊断出来。由于其为良性,不进行睾丸切除术而切除肿瘤即可治愈。

结论

在处理儿童睾丸肿块时,提高对脾性腺融合的认识对于防止不必要的根治性手术干预至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7014/10362365/516e953c122b/gr1.jpg

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