Androgen insensitivity syndrome diagnosed in an elderly patient during a strangulated inguinal hernia repair.
BACKGROUND
A strangulated inguinal hernia is a common indication for emergency surgery. In comparison, complete testicular feminization is a rare genetic disease that can present with an inguinal hernia because of ectopically positioned testicles.


METHODS
A 70-year-old female was admitted to the emergency service complaining of a painful swelling in the right inguinal region for 1 day. The physical examination indicated a strangulated inguinal hernia and surgery was performed. On exploring the inguinal region, a strangulated indirect inguinal hernia and hard 2×3-cm mass were detected. The histopathological examination of the excised mass showed testicular tissue, and complete testicular feminization (CTF) was diagnosed after further examinations.


CONCLUSIONS
Androgen insensitivity syndrome (AIS), the most frequent cause of male pseudohermaphroditism. The diagnosis of patients with AIS is usually made at the beginning of the second decade when a healthy person with a female phenotype complains of no menarche. Making a first diagnosis after the 5th decade is extremely rare.


CONCLUSIONS
While AIS can be diagnosed in early adulthood, cases might not bediagnosed until the patient is of advanced age.
Sakarya University Research and Educational Hospital, Department of General Surgery, Turkey.
Yusuf
Y
Arslan
Fatih
F
Altintoprak
Orhan Veli
OV
Ozkan
Omer
O
Yalkın
Yasemin
Y
Gunduz
Zeynep
Z
Kahyaoglu
Androgen insensitivity; Elderly; Testicular feminization