Unusual Presentation of Splenogonadal Fusion in a 7-Month-Old Male Infant

Splenogonadal fusion is a rare congenital anomaly characterized with anomalous fusion of the spleen and the gonad or mesonephric derivatives. Herein, we report the case of a 7-month-old boy with unusual presentation of splenogonadal fusion. A 7-month-old boy was brought to the Urology Clinic, Imam Reza Hospital, Mashhad, Iran, by his parents complaining of a painless palpable scrotal mass with a sudden increase in the size after a respiratory infection. The patient underwent surgery with a suspicion of testicular malignant tumors. However, pathologic study revealed a benign mass with splenic origin. Preoperative diagnosis of splenogonadal fusion is almost impossible and most cases undergo an unnecessary orchiectomy, especially when the clinical presentation resembles a primary testicular neoplasm. Although surgery is necessary to remove the benign splenic tissue as well, proper knowledge and consideration along with appropriate imaging studies and histopathological examination contribute in avoiding an unnecessary orchiectomy.