Splenogonadal Fusion

HomeRadioGraphicsVol. 44, No. 4 PreviousNext Cases from the Cooky JarFree AccessSplenogonadal FusionJia Chu, Mahati Mokkarala, Meng Zhang, Irene Dixe de Oliveira Santo, M. Hunter Lanier Jia Chu, Mahati Mokkarala, Meng Zhang, Irene Dixe de Oliveira Santo, M. Hunter Lanier Author AffiliationsFrom the Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 S Kingshighway Blvd, Campus Box 8131, St Louis, MO 63110 (J.C., M.M., M.H.L.); Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Ga (M.Z.); and Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Conn (I.D.d.O.S.).Address correspondence to M.H.L. (email: [email protected]).Jia ChuMahati MokkaralaMeng ZhangIrene Dixe de Oliveira SantoM. Hunter Lanier Published Online:Mar 21 2024https://doi.org/10.1148/rg.230224MoreSectionsPDF ToolsAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookXLinked In Splenogonadal fusion is a rare congenital malformation in which an abnormal connection exists between the spleen and the gonad (Fig 1) (1). This connection occurs during weeks 5–8 of gestation before gonadal descent, when gastric rotation brings the spleen and gonadal tissue into close proximity (Fig 2) (2). Continuous and discontinuous variants have been described (Fig 3). Continuous variants have a direct connection between the spleen and the gonad, usually between the upper pole of the spleen and the upper pole of the gonad. Conversely, the discontinuous variant has no direct connection, but ectopic splenic tissue is fused to the gonad (1,2). The continuous variant of splenogonadal fusion is often associated with additional congenital abnormalities, most commonly limb defects and micrognathia (3,4). Fewer than 200 cases of splenogonadal fusion have been reported in the literature. Most cases occur in males (male to female ratio, 15:1), who frequently present with cryptorchidism or a testicular mass, more commonly on the left. Although splenogonadal fusion is not believed to increase the risk of testicular cancer, there is a known association of cryptorchidism with testicular malignancy (3). Treatment is controversial, with some advocating for surgery to exclude testicular tumor. If surgery is performed, splenic tissue can often be dissected off of the testis, making orchiectomy usually unnecessary (2).Figure 1. Continuous form of splenogonadal fusion in a 30-year-old man with congenital heart disease. (A) Oblique coronal contrast-enhanced CT image through the left upper abdomen shows an elongated appearance of the spleen, which follows the expected course of the testicular descent (arrows). (B) Oblique coronal contrast-enhanced CT image through the pelvis shows the right spermatic cord and testis (arrow) but absence of these structures on the left (*). (C) Transaxial contrast-enhanced CT image shows a subtle ovoid area of relative hypoattenuation in the anteroinferior aspect of the elongated splenic tip (arrowhead), best seen with narrow window settings. (D) Three-dimensional surface-rendered image shows the course of the left gonadal vein from the inferior aspect of the spleen to the left renal vein.Figure 1.Download as PowerPointFigure 2. Illustration depicts the pathogenesis of splenogonadal fusion, which occurs due to an insult between weeks 5 and 8 of embryogenesis, when gastric rotation brings the spleen and genital ridge into close proximity.Figure 2.Download as PowerPointFigure 3. Illustration depicts the manifestations of continuous and discontinuous forms of splenogonadal fusion.Figure 3.Download as PowerPointDisclosures of conflicts of interest.—All authors have disclosed no relevant relationships.References1. Pomara G. Splenogonadal fusion: a rare extratesticular scrotal mass. RadioGraphics 2004;24(2):417. Link, Google Scholar2. Kadouri Y, Carnicelli D, Sayegh HE, Benslimane L, Nouini Y. Pathogenesis, Diagnosis, and Management of Splenogonadal Fusion: A Literature Review. Case Rep Urol 2020;2020:8876219. Medline, Google Scholar3. Qadeer A, Quincey C, Gill K, Paddock M. Splenogonadal fusion: a radiologic-pathologic correlation and review of the literature. Radiol Case Rep 2020;15(10):1817–1822. Crossref, Medline, Google Scholar4. Varma DR, Sirineni GR, Rao MV, Pottala KM, Mallipudi BV. Sonographic and CT features of splenogonadal fusion. Pediatr Radiol 2007;37(9):916–919. Crossref, Medline, Google ScholarArticle HistoryReceived: Oct 23 2023Accepted: Oct 27 2023Published online: Mar 21 2024 FiguresReferencesRelatedDetailsRecommended Articles Role of Imaging in the Evaluation of Male InfertilityRadioGraphics2017Volume: 37Issue: 3pp. 837-854US of the Inguinal Canal: Comprehensive Review of Pathologic Processes with CT and MR Imaging CorrelationRadioGraphics2016Volume: 36Issue: 7pp. 2028-2048Pathologic Conditions at Imaging of the Spermatic CordRadioGraphics2022Volume: 42Issue: 3pp. 741-758From Inguinal Hernias to Spermatic Cord Lipomas: Pearls, Pitfalls, and Mimics of Abdominal and Pelvic HerniasRadioGraphics2017Volume: 37Issue: 7pp. 2063-2082Radiologic Assessment of Native Renal Vasculature: A Multimodality ReviewRadioGraphics2017Volume: 37Issue: 1pp. 136-156See More RSNA Education Exhibits Ticking Time Bombs: Testicular TumorsDigital Posters2020Unraveling Scrotal Pathology: Acute, Chronic, Congenital And Neoplastic ManifestationsDigital Posters2021Gonadal Vein - The Omitted by LaneDigital Posters2022 RSNA Case Collection Duplicated Inferior Vena CavaRSNA Case Collection2021Sister Mary Joseph NoduleRSNA Case Collection2021Testicular SeminomaRSNA Case Collection2020 Vol. 44, No. 4 Metrics Altmetric Score PDF download