Chen F P, Chu K K, Soong Y K
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital, Keelung, Taiwan, R.O.C.
Changgeng Yi Xue Za Zhi. 1991 Dec;14(4):264-8.
46,xy pure gonadal dysgenesis is a rare disorder, which is characterized by female phenotype, infantile female external genitalia, deficient secondary sexual development, hypoplastic uterus and fallopian tubes, and streak gonads. A 17-year-old female phenotypic patient was admitted due to primary amenorrhea, who also had poor breast development, deficient axillary and pubic hairs, and infantile female external genitalia. Lymphocyte culture of peripheral blood for chromosome study revealed 46,XY normal male karyotype. Endocrine evaluation demonstrated low estrogen, high LH and FSH levels, and normal testosterone level of female range. According to the high risk of germ cell tumor occurrence in 46,XY gonadal dysgenesis, bilateral salpingo-oophorectomy and total hysterectomy were performed. Pathology of the left ovary revealed gonadoblastoma accidentally. Thereafter, she received regular hormone therapy and had generally felt well. Secondary sexual development was noted one year later.
46,XY单纯性腺发育不全是一种罕见的疾病,其特征为女性表型、幼稚型女性外生殖器、继发性性征发育不全、子宫和输卵管发育不良以及条索状性腺。一名17岁表型为女性的患者因原发性闭经入院,该患者还存在乳房发育差、腋毛和阴毛缺乏以及幼稚型女性外生殖器。对外周血进行淋巴细胞培养以进行染色体研究,结果显示为46,XY正常男性核型。内分泌评估显示雌激素水平低、促黄体生成素(LH)和促卵泡生成素(FSH)水平高,睾酮水平处于女性正常范围。鉴于46,XY性腺发育不全患者发生生殖细胞肿瘤的风险高,遂行双侧输卵管卵巢切除术和全子宫切除术。左侧卵巢病理检查意外发现性腺母细胞瘤。此后,她接受了规律的激素治疗,总体感觉良好。一年后出现继发性性征发育。