Abstract
Background: Splenogonadal fusion (SGF) is a rare congenital anomaly characterized by ectopic splenic tissue and an aberrant connection with the gonad. SGF predominantly affects males and is typically discovered incidentally during evaluations for cryptorchidism or inguinal hernia.
Case presentation: In this study, we present a case of a 28-year-old male undergoing routine medical examination for military service, in whom left-sided cryptorchidism was found on physical examination. Imaging revealed an atrophic undescended left testis and associated hypoechoic lesions in the distal inguinal region on scrotal ultrasound. Further evaluation with pelvic magnetic resonance imaging localized the left testis within the pelvic cavity. Diagnostic laparoscopy confirmed SGF involving the left testis, and a left orchiectomy was performed. Histopathological analysis confirmed the presence of atrophic testicular tissue with seminiferous tubules and focal splenic tissue.
Conclusion: This case underscores the importance of considering SGF in patients with undescended testes to avoid misdiagnosis and unnecessary orchiectomy and highlights the diagnostic challenges of SGF in atypical cryptorchidism presentations.

Key words: Splenogonadal fusion, Undescended testicle