Abstract
BACKGROUND: Splenogonadal fusion (SGF) is a rare congenital anomaly that presents with an abnormal connection between the gonad and the spleen. Misdiagnosis can lead to unnecessary surgical interventions, underscoring the need for thorough pre-operative assessments and differential diagnoses. Histopathological and imaging evaluations are essential for accurate diagnosis and appropriate management. CASE PRESENTATION: A 35-year-old male presented with an acute swelling and pain in the scrotum and the inguinal region. The patient's medical and surgical history was unremarkable, with no known congenital anomalies. Emergency surgery revealed a fibrous cord extending between the orthotopic spleen and the left testis with multiple tissue formations along it in a rosary-like shape. The reason for the acute presentation was double torsion of the abnormal cord at the internal inguinal ring and near the junction between the fibrous cord and the testis. The abnormal tissue was resected and histopathological examination confirmed splenic tissue. confirming the final diagnosis of splenogonadal fusion (continuous form). CONCLUSION: SGF is a rare congenital anomaly which is difficult to diagnose that is difficult to diagnose due to its nonspecific clinical presentation. Most SGF cases are diagnosed during the exploratory surgery, no single definitive diagnostic modality exists; however, imaging and splenic scintigraphy may aid in selected cases. Surgeons should consider this benign condition in the differential diagnoses of left inguinal or scrotal masses to avoid unnecessary orchiectomy.