Chiang Chao-Yan, Tsai Jen-Wei, Wang Hua-Pin, Sung Ya-Zhu, Chang Li-Ching
E-DA Hospital/I-Shou University, Kaohsiung, Taiwan.
Int J Surg Pathol. 2010 Oct;18(5):440-2. doi: 10.1177/1066896909354338. Epub 2010 Feb 16.
Persistent Müllerian duct syndrome (PMDS) with seminoma, hernia uterine inguinale, and transverse testicular ectopia is rare. A 41-year-old phenotypic man with 46 XY karyotype was admitted with nonpainful bulging mass in the left inguinoscrotal region. Two distinct masses were identified by sonography and computed tomography. No testis was apparent on the right side. Excisional specimens revealed seminoma and scrotal uterus. Histopathology of seminoma showed enhanced CD117 immunohistochemical staining. The other inguinal mass was consistent with uterine tissue and was associated with the vas deferens in its lateral aspect. Radiation therapy was performed after the orchiectomy and scrotal hysterectomy. The patient remains free of recurrence after 1-year follow-up assessment. The presence of a unilateral inguinal hernia with a large mass associated with a contralateral nonpalpable testis indicates the presence of PMDS with hernia uterine inguinale and transverse testicular ectopia.
持续性苗勒管综合征(PMDS)合并精原细胞瘤、腹股沟子宫疝和睾丸横过异位较为罕见。一名46 XY核型的41岁表型男性因左侧腹股沟阴囊区域无痛性隆起肿块入院。超声和计算机断层扫描发现两个不同的肿块。右侧未发现明显睾丸。切除标本显示为精原细胞瘤和阴囊子宫。精原细胞瘤的组织病理学显示CD117免疫组化染色增强。另一个腹股沟肿块与子宫组织一致,其外侧与输精管相连。睾丸切除和阴囊子宫切除术后进行了放射治疗。1年随访评估后,患者无复发。单侧腹股沟疝伴巨大肿块且对侧睾丸无法触及提示存在合并腹股沟子宫疝和睾丸横过异位的持续性苗勒管综合征。