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Testicular feminization syndrome diagnosed in an elderly patient at surgery. A case report.
Panminerva Med. 1996 Sep; 38(3):193-8.PM

Abstract

A case of Morris' syndrome in which the diagnosis has been realized only in old age is reported. A 69 year-old patient, with female external genitalia and secondary sexual characteristics, was referred to us with a diagnosis of a mass in the right inguinal region. Her personal history was based on a primary amenorrhoea, which was unsuccessfully investigated since she was adolescent. At the age of 63, during surgery for a left inguinal hernia realized in another hospital, a testis-like mass with the spermatic cord was casually found. During our hospitalization, a surgical removal of the right inguinal mass was performed, and the histologic examination showed the presence of a dominant sclerohyalin testicular tissue without evidence of seminal epithelium and sparse focuses of Leydig cells hyperplasia. Besides, the determination of gonadotropins and sex hormones yielded an increased production of LH, FSH, estradiol, testosterone and androstenedione. A cytogenetic analysis showed a 46, XY karyotype. The diagnosis realized only in old age has compelled the patient to live all her life, from sexual maturity, with indecision and doubt, and without a clinical explanation of fundamental utility even from the psychological point of view. Finally, in our patient the absence of cytologic aspect of malignant transformation in the removed testes in a six years period, seem fortuitous. It is always necessary to consider Morris' syndrome among the possible diseases causing primary amenorrhoea in the clinical evaluation of young phenotypic female patients.

Authors+Show Affiliations

Department of General Surgery, Civil Hospital of Giaveno, Turin, Italy.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

9009687

Citation

Monaco, A, et al. "Testicular Feminization Syndrome Diagnosed in an Elderly Patient at Surgery. a Case Report." Panminerva Medica, vol. 38, no. 3, 1996, pp. 193-8.
Monaco A, La Brocca A, Verna C, et al. Testicular feminization syndrome diagnosed in an elderly patient at surgery. A case report. Panminerva Med. 1996;38(3):193-8.
Monaco, A., La Brocca, A., Verna, C., Moncelli, G., Berardengo, E., & Bollito, E. (1996). Testicular feminization syndrome diagnosed in an elderly patient at surgery. A case report. Panminerva Medica, 38(3), 193-8.
Monaco A, et al. Testicular Feminization Syndrome Diagnosed in an Elderly Patient at Surgery. a Case Report. Panminerva Med. 1996;38(3):193-8. PubMed PMID: 9009687.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Testicular feminization syndrome diagnosed in an elderly patient at surgery. A case report. AU - Monaco,A, AU - La Brocca,A, AU - Verna,C, AU - Moncelli,G, AU - Berardengo,E, AU - Bollito,E, PY - 1996/9/1/pubmed PY - 1996/9/1/medline PY - 1996/9/1/entrez SP - 193 EP - 8 JF - Panminerva medica JO - Panminerva Med VL - 38 IS - 3 N2 - A case of Morris' syndrome in which the diagnosis has been realized only in old age is reported. A 69 year-old patient, with female external genitalia and secondary sexual characteristics, was referred to us with a diagnosis of a mass in the right inguinal region. Her personal history was based on a primary amenorrhoea, which was unsuccessfully investigated since she was adolescent. At the age of 63, during surgery for a left inguinal hernia realized in another hospital, a testis-like mass with the spermatic cord was casually found. During our hospitalization, a surgical removal of the right inguinal mass was performed, and the histologic examination showed the presence of a dominant sclerohyalin testicular tissue without evidence of seminal epithelium and sparse focuses of Leydig cells hyperplasia. Besides, the determination of gonadotropins and sex hormones yielded an increased production of LH, FSH, estradiol, testosterone and androstenedione. A cytogenetic analysis showed a 46, XY karyotype. The diagnosis realized only in old age has compelled the patient to live all her life, from sexual maturity, with indecision and doubt, and without a clinical explanation of fundamental utility even from the psychological point of view. Finally, in our patient the absence of cytologic aspect of malignant transformation in the removed testes in a six years period, seem fortuitous. It is always necessary to consider Morris' syndrome among the possible diseases causing primary amenorrhoea in the clinical evaluation of young phenotypic female patients. SN - 0031-0808 UR - https://www.unboundmedicine.com/medline/citation/9009687/Testicular_feminization_syndrome_diagnosed_in_an_elderly_patient_at_surgery__A_case_report_ DB - PRIME DP - Unbound Medicine ER -