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Licensed Unlicensed Requires Authentication Published by De Gruyter December 16, 2014

Ovotesticular disorder of sex development with unusual karyotype: patient report

  • Georgette Beatriz Paula , Juliana Gabriel Ribeiro Andrade , Guilherme Guaragna-Filho EMAIL logo , Letícia Esposito Sewaybricker , Márcio Lopes Miranda , Andréa Trevas Maciel-Guerra and Gil Guerra-Júnior

Abstract

Background: Ovotesticular disorder of sex development (OT-DSD) (true hermaphroditism) is an anatomopathological diagnosis based on the findings of testicular and ovarian tissues in the same subject, in the same gonad (ovotestis), or in separate gonads. OT-DSD is a rare cause of sex ambiguity, and the most common karyotype is 46,XX; mosaics and chimeras are found only in 10%–20%.

Aim: To report a case of an OT-DSD patient with a rare karyotype constitution.

Case report: A 2-month-old child with male sex assignment was referred to our clinic for investigation of sex ambiguity. He was the second child of healthy unrelated parents; pregnancy and labor were uneventful. On physical examination, he had a 2.3-cm phallus and perineal hypospadias (Prader grade III); the right gonad was in the labioscrotal fold and the left was found in the inguinal channel. Karyotype was 46,XX/47,XXY/48,XXYY. Anatomopathological examination of gonads revealed right testis and left ovotestis. The male sex assignment was maintained; the child underwent left gonadectomy, removal of Mullerian structures and urethroplasty.

Conclusion: A thorough revision of literature revealed a single case of OT-DSD with the same chromosome constitution. Gonadal biopsy is necessary to establish diagnosis in cases of sex chromosome mosaicism.


Corresponding author: Guilherme Guaragna-Filho, Departamento de Pediatria, FCM, UNICAMP, Rua Tessalia Vieira de Camargo, 126, 13083-887 Campinas, SP, Brasil, Phone: +55-19-35217353, Fax: +55-19-35217322, E-mail:

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Received: 2014-8-6
Accepted: 2014-10-27
Published Online: 2014-12-16
Published in Print: 2015-5-1

©2015 by De Gruyter

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