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腹腔镜下犬双侧性腺切除术:一例 78,XX/78,XY 嵌合体伴生殖器官发育不全的病例报告

Laparoscopic gonadectomy in a dog with 78,XX/78,XY chimerism and underdeveloped reproductive organs.

出版信息

J Am Vet Med Assoc. 2021 Jan 1;258(1):80-84. doi: 10.2460/javma.258.1.80.

Abstract

CASE DESCRIPTION

A 1-year-old externally sexually intact female Great Dane was referred for further evaluation of abnormal and underdeveloped internal reproductive organs.

CLINICAL FINDINGS

Physical examination findings included a cranioventrally displaced vulva and a grade 2/6 left apical systolic heart murmur. No uterus or ovaries were identified during abdominal ultrasonography. Computed tomography with retrograde vaginourethrography revealed an underdeveloped uterus and possible left intra-abdominal gonad. Karyotyping revealed mixed sex chromosomes (70% XY and 30% XX). Analysis of a serum sample yielded positive results for anti-Müllerian hormone; other findings included mid range estradiol concentration (48.2 pg/mL [within reference intervals for sexually intact and neutered males and females]), low progesterone concentration (< 0.2 ng/mL [within reference intervals for anestrous females]), and low testosterone concentration (< 20 ng/dL [similar to the expected concentration in neutered males]). Overall, the results of the sex hormone analyses were consistent with findings for either a sexually intact female or a neutered male dog. The dog's cardiac structure and function were echocardiographically normal.

TREATMENT AND OUTCOME

The dog was anesthetized and underwent laparoscopic gonadectomy. The gonads, although abnormal and underdeveloped, were readily identified intraoperatively and successfully removed. On the basis of histologic findings, the removed gonads were confirmed to be rudimentary testicles. The dog recovered from anesthesia and surgery without complications.

CLINICAL RELEVANCE

Laparoscopic surgery was effective for visualization of abnormal and hypoplastic reproductive organs when abdominal ultrasonography and CT were of limited diagnostic usefulness, and laparoscopic surgery allowed straightforward gonadectomy in a 78,XX/78,XY chimeric dog.

摘要

病例描述

一只 1 岁、外部生殖器完整的雌性大丹犬因异常和发育不良的内部生殖器官而被转介进行进一步评估。

临床发现

体格检查结果包括阴门颅向移位和 2/6 级左心尖收缩期心脏杂音。腹部超声检查未发现子宫或卵巢。逆行阴道尿道造影的计算机断层扫描显示子宫发育不良和可能的左侧腹腔内性腺。核型分析显示混合性性染色体(70% XY 和 30% XX)。血清样本分析结果抗苗勒管激素阳性;其他发现包括雌二醇浓度处于中间范围(48.2 pg/mL[在有正常生殖和去势雄性和雌性的参考区间内])、孕酮浓度低(<0.2 ng/mL[在发情期雌性的参考区间内])和睾酮浓度低(<20 ng/dL[与去势雄性的预期浓度相似])。总的来说,性激素分析的结果与有正常生殖功能的雌性或去势雄性犬的结果一致。该犬的心脏结构和功能经超声心动图检查正常。

治疗和预后

该犬被麻醉并接受了腹腔镜性腺切除术。尽管这些性腺异常且发育不良,但在手术中很容易识别,并成功切除。根据组织学发现,切除的性腺被确认为原始睾丸。该犬在麻醉和手术中恢复顺利,无并发症。

临床意义

当腹部超声和 CT 检查的诊断作用有限时,腹腔镜手术可有效观察异常和发育不良的生殖器官,并且腹腔镜手术可在 78,XX/78,XY 嵌合体犬中直接进行性腺切除术。

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