Images
Doctor's Information
Name : Morteza
Family : Sanei Taheri
Affiliation :Radiology Department,Shohada Tajrish Hospital,SBMU
Academic Degree : Associate Professor of Radiology
Email :
This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : Razmin Aslani
Case Section
Uroradiolgy&Genital Male Imaging
Patient's Information
Gender : Male
Age : 25
Clinical Summary
A 25 years old man with history of UDT and Lt inguinal swelling
Imaging Findings
In Pelvic MRI (sagittal T2, axial T2FS, coronal T1) prostate is seen in its normal anatomical position,seminal vesicles are attached to a tubular fluid-filled structure which is uterous! (with hydrometra) and 2 gonads can be seen near tubular structure (fallopian tubes) Also thickening of urine bladder wall and indirect inguinal hernia can be seen in left scrotum.
Differential Diagnosis
--------
Final Diagnosis
true hermaphroditism (PMDS)
Discussion (Related Text)
Hermaphroditism is presence of both ovarian and testicular tissue and of ambiguous morphologic criteria of sex, a rare condition in human beings. Hermaphroditism is not to be confused with pseudohermaphroditism, in which an individual has only one kind of gonad but has significant secondary sex characters typical of the opposite sex. Bilateral hermaphroditism: that in which gonadal tissue typical of both sexes occurs on each side of the body. Lateral hermaphroditism : presence of gonadal tissue typical of one sex on one side of the body and typical of the other sex on the opposite side. Transverse hermaphroditism : that in which the external genital organs are typical of one sex and the gonads typical of the other sex. True hermaphroditism : coexistence in the same person of both ovarian and testicular tissue, with somatic characters typical of both sexes. Unilateral hermaphroditism : presence of gonadal tissue typical of both sexes on one side and of only an ovary or a testis on the other.(1) Pseudohermaphroditism: a state in which the gonads are of one sex, but one or more contradictions exist in the morphologic criteria of sex. In female p., the individual is genetically female and has female gonads (ovaries) but has significant male secondary sex characters. In male p., the individual is genetically male and has male gonads (testes) but has significant female secondary sex characters(2) True Gonadal Intersex: Here the person must have both ovarian and testicular tissue. This may be in the same gonad (an ovotestis), or the person might have one ovary and one testis. The person may have XX chromosomes, XY chromosomes, or both. The external genitals may be ambiguous or may appear to be female or male. This condition used to be called true hermaphroditism. In most people with true gonadal intersex, the underlying cause is unknown, although in some animal studies it has been linked to exposure to common agricultural pesticides.(3-4) In persistent mullerian duct syndrome (PMDS) The child has XY chromosomes typical of a male. The child has a male body and an internal uterus and fallopian tubes because his body did not produce Müllerian inhibiting factor during fetal development.(5)
References
1-Miller-Keane Encyclopedia and Dictionary of Medicine, Nursing, and Allied Health, Seventh Edition. © 2003 by Saunders, an imprint of Elsevier, Inc 2-Dorland's Medical Dictionary for Health Consumers. © 2007 by Saunders, an imprint of Elsevier, Inc 3-Allen L. Disorders of sexual development. Obstet Gynecol Clin North Am. 2009;36:25-45. 4-Donohoue PA. Disorders of sex development (intersex). In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 582. 5-Anne Fausto-Sterling|Anne Fausto-Sterling (2000). Sexing the Body: Gender Politics and the Construction of Sexuality. New York: Basic Books.(read it at wikipedia)
end faqaq