Cortes D, Thorup J M, Visfeldt J
Department of Pediatric Surgery, University Hospital, Copenhagen, Denmark.
Br J Urol. 1996 Feb;77(2):285-90. doi: 10.1046/j.1464-410x.1996.89022.x.
To obtain new information about the pathogenesis of cryptorchidism.
Published reports of 111 males with splenogonadal fusion were examined and the presence and type of cryptorchidism and the degree of continuity between the spleen and gonads determined.
Of the 111 cases, 31% had cryptorchidism and of these 59% were bilaterally cryptorchid; 26% and 65% had right and left intra-abdominal testes, respectively. Of those with continuous splenogonadal fusion, 44% had cryptorchidism. Solely cryptorchid cases with splenogonadal fusion had reported bilateral absence of both legs, imperforate anus, spina bifida, diaphragmatic hernia and hypospadias.
An hypothesis is proposed that the abnormal development of the diaphragmatic ligaments of the testes may lead to lack of their involution, with consequent cryptorchidism. In the case of splenogonadal fusion, the abnormal ligaments are colonized by splenic cells, possibly because of an abnormal proximity to the splenic anlage, with the resulting abnormal ligament persisting as the splenic cord and thus resulting in cryptorchidism. The basic abnormality may be in the connections of the diaphragmatic ligaments, caused by abnormal midline development in the third to fourth week of gestation.
获取有关隐睾症发病机制的新信息。
对111例患有脾性腺融合症男性的已发表报告进行检查，确定隐睾症的存在及类型以及脾脏与性腺之间的连续程度。
在111例病例中，31%患有隐睾症，其中59%为双侧隐睾；分别有26%和65%的患者右侧和左侧睾丸位于腹腔内。在脾性腺连续融合的患者中，44%患有隐睾症。单纯性隐睾合并脾性腺融合的病例报告有双腿双侧缺失、肛门闭锁、脊柱裂、膈疝和尿道下裂。
提出一种假说，即睾丸的膈韧带异常发育可能导致其退化缺失，从而引发隐睾症。在脾性腺融合的情况下，异常韧带被脾细胞占据，可能是由于与脾原基异常接近，导致异常韧带作为脾索持续存在，进而导致隐睾症。基本异常可能在于膈韧带的连接，这是由妊娠第三至第四周中线发育异常引起的。
