Splenogonadal fusion diagnosed by spleen scintigraphy.

Splenogonadal fusion (SGF) is a rare congenital malformation characterized by fusion of the spleen and a gonad (almost always the left one) frequently associated with orofacial and/or limb developmental abnormalities. Only 125 cases were reported between 1883 and 1994. This report concerns a case of SGF in a 20-yr-old woman with an accidental finding of a splenic space-occupying lesion protruding into the lower abdomen in ultrasound and CT. Radiocolloid spleen scintigraphy and SPECT proved to be the best procedure to establish the correct diagnosis of SGF. As SGF is often asymptomatic, more liberal use of splenic scintigraphy is suggested in patients with congenital limb and/or orofacial anomalies. SGF should be included among the differential diagnoses of left abdominal, pelvic or scrotal masses.

[Well-differentiated thyroid carcinoma].

18 cases of well-differentiated thyroid carcinoma are described, of which 5 were papillary or mixed carcinomas and 3 were follicular. In 12 of 14 in whom radio-isotope scanning was performed, a cold or indeterminate nodule was found. Fine needle aspiration was positive and concordant with the operative histological findings in half the cases examined. In 4 hemithyroidectomy was performed, and in 14 total thyroidectomy. Thyroid remnants were found on scanning in all of the 14. These remnants were ablated with radioactive iodine (131I). An ablative dose of 30 millicurie was insufficient in almost all cases and a second dose was required. 3 cases with regional spread of the tumor were reoperated, and large ablative doses of 131I(150-170 mCi) were given. In 14 cases clinical remission was achieved. Followup included ultrasonography and total body 131I scans.