Acta Med. 2021, 64: 42-45

https://doi.org/10.14712/18059694.2021.7

Ovotesticular Disorder of Sexual Development and Non-Palpable Testis

Radek Štichhauera, Antonín Šafusa, David Neumannb, Ivo Novákc, Vladana Skutilovád, Jan Lacoe

aDepartment of Pediatric Surgery, University Hospital Hradec Králové, Faculty of Medicine Hradec Králové, Charles University, Czech Republic
bDepartment of Pediatrics, University Hospital Hradec Králové, Faculty of Medicine Hradec Králové, Charles University, Czech Republic
cDepartment of Urology, University Hospital Hradec Králové, Faculty of Medicine Hradec Králové, Charles University, Czech Republic
dDepartment of Medical Genetics, University Hospital Hradec Králové, Faculty of Medicine Hradec Králové, Charles University, Czech Republic
eFingerland Department of Pathology, University Hospital Hradec Králové, Faculty of Medicine Hradec Králové, Charles University, Czech Republic

Received June 1, 2020
Accepted October 24, 2020

Disorders of sexual development (DSD) refers to a group of diseases that links the mismatch between an individual’s genetic and gonadal development and its phenotype. Ovotesticular DSD (true hermaphroditism) is one such disease, in which both male and female gonads are present. A 15-year-old boy with a history of surgery for non-palpable testis was examined due to bilateral gynecomastia and known gonosomal mosaic of Klinefelter syndrome. The external genital was matured as male and, in the left half of the scrotum, there was a testicle of normal size. Despite uncertain resistance on the right side, however, the right testis was not palpable. Revision of the right groin revealed a surprising finding in the form of an ovary with a dilated fallopian tube, both of which were completely removed. Surgical revision of the left testis with biopsy was performed. The surgery was completed with a bilateral mastectomy. The postoperative course was uncomplicated, and the boy is content and fully integrated into his peer group. True hermaphroditism is a rare type of DSD. In the case described, DSD was not exhibited until puberty, after an examination for gynecomastia. The case also confirms the necessity of clarification and long-term follow-up of patients with unclear findings during surgery for non-palpable testis. Diagnostic laparoscopy is clearly indicated in these situations.

Funding

The authors are supported by the program PROGRES Q40/11 and by the project BBMRI-CZ LM2018125.

References

13 live references