title: Mixed gonadal dysgenesis: whole life follow-up of a rare case.
abstract: There are two forms of gonadal dysgenesis - mixed and pure. In the mixed form, some differentiated gonads as well as some either ovarian or testicular rudiments are present. This form results in a number of phenotypes with a possibility of malignant transformation. In the pure form occurring in female gender, also some rudimental gonads are bilaterally present. In the case of simultaneous presence of Y chromosome, also some malignant transformation may appear (Siklar et al. 2007). Chromosomal aberrations are present in 2-7 % adult pairs with fertility disorders and in 0.6 % of newborns. However, only few cases with similar chromosomal aberrations were described so far (Roubin et al. 1977; Alexander et al. 1978; Teyssier et al. 1982; Caglayan et al. 2009). Mixed gonadal dysgenesis presents as a unilateral testis, usually intraabdominal, also with a streak gonad on contralateral side, and persistent mullerian structures. 45X/45XY karyotype is the most frequent in such cases with predominance of 45X cells in both peripheral lymphocytes and gonads. We present a rare case of a left undescended testis, normally descended right testis, with penoscrotal hypospadias, who had a normal karyotype and whose histopathological findings were endometrial tissue and fallopian tube in left testicular biopsy. Gonadal dysgenesis should always be kept in mind because of a possibility of undescended testis and proximal hypospadias. If karyotype reveals a 46XY gonadal dysgenesis, these patients need the careful follow-up to screen for gonadoblastoma in remaining normal testis. Subjecting the patients to prophylactic orchidectomy with hormone replacement can be an additional option in such patients.
authors.affiliation: 5th Department of Internal Medicine, Comenius University, Slovakia. zuzanateliarova@centrum.sk
authors.forename: Z
authors.initials: Z
authors.lastname: Teliarova
authors.forename: L
authors.initials: L
authors.lastname: Baqi
authors.forename: Z
authors.initials: Z
authors.lastname: Misikova
authors.forename: M
authors.initials: M
authors.lastname: Pura
authors.forename: P
authors.initials: P
authors.lastname: Jackuliak
authors.forename: J
authors.initials: J
authors.lastname: Payer
mesh_terms: D000328:Adult; D000367:Age Factors; D002869:Chromosome Aberrations; D005260:Female; D005500:Follow-Up Studies; D006060:Gonadal Dysgenesis, Mixed / Q000235:genetics* / Q000473:pathology* / Q000601:surgery; D006801:Humans; D007006:Hypogonadism / Q000235:genetics / Q000473:pathology; D008297:Male; D050090:Ovotesticular Disorders of Sex Development / Q000235:genetics* / Q000473:pathology* / Q000601:surgery