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True hermaphroditism presenting as bilateral gynecomastia in an adolescent phenotypic male
Sophia Ouhilal1, Jack Turco, Ajay Nangia
1Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology and Infertility, Dartmouth Medical School, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire.
Objective:
To report a rare case of true hermaphroditism presenting in adolescence as bilateral gynecomastia in a phenotypic male.
Design:
Case report.
Setting:
Academic medical center.
Patient(S):
A 19-year-old phenotypic male who presented with pronounced bilateral gynecomastia and was ultimately diagnosed with true hermaphroditism.
Intervention(S):
Endoscopic removal of the internal female genital tract (hemiuterus and ovary), reduction mammoplasty, repair of penile chordee, and left testicular prosthesis placement.
Main Outcome Measure(S):
Diagnosis and treatment of true hermaphroditism.
Result(S):
Bilateral mammoplasties, repair of a penile chordee, placement of a left testicular prosthesis, and excision of the left hemiuterus and ovary resulted in return to testicular function in this true hermaphrodite.
Conclusion(S):
Although rare, true hermaphroditism should be suspected in male patients presenting with bilateral breast enlargement in adolescence.
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