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      Swyer Syndrome: A Case Report Translated title: Swyer 증후군: 증례 보고

      case-report

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          Abstract

          Swyer syndrome is a rare form of primary amenorrhea resulting from gonadal dysgenesis. It is characterized by the presence of a female phenotype with a 46, XY karyotype. In our case, CT scans revealed the absence of the uterus and bilateral ovaries of the 16-year-old female patient. Calcific nodules were found in both inguinal areas, which were suspected to be calcified atrophic testes. A chromosomal study confirmed the diagnosis of Swyer syndrome. Herein, we report a rare case of Swyer syndrome.

          Translated abstract

          Swyer 증후군은 생식샘 발달에 영향을 미치는 희귀 유전질환으로 원발성 무월경의 드문 원인이다. 이 증후군은 46, XY 핵형을 가지나 표현형은 여성으로 나타나는 특징을 보인다. 이번 증례는 원발성 무월경을 주소로 내원한 16세 여성으로 컴퓨터단층촬영에서 자궁과 양측 난소가 관찰되지 않으며 양쪽 사타구니 부위에서 위축된 고환으로 보이는 석회화 결절이 관찰되었다. 염색체 연구에서 46, XY로 Swyer 증후군으로 확진되었다. 이에 저자들은 원발성 무월경의 드문 원인으로 Swyer 증후군을 보고하고자 한다.

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          Most cited references7

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          Consensus statement on management of intersex disorders. International Consensus Conference on Intersex.

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            Germ cell tumors in the intersex gonad: old paths, new directions, moving frontiers.

            The risk for the development of germ cell tumors is an important factor to deal with in the management of patients with disorders of sex development (DSD). However, this risk is often hard to predict. Recently, major progress has been made in identifying gene-products related to germ cell tumor development (testis-specific protein-Y encoded and octamer binding transcription factor 3/4) and in recognizing early changes of germ cells (maturation delay, preneoplastic lesions, and in situ neoplasia). The newly recognized "undifferentiated gonadal tissue" has been identified as a gonadal differentiation pattern bearing a high risk for the development of gonadoblastoma. It is expected that the combination of these findings will allow for estimation of the risk for tumor development in the individual patient (high risk/intermediate risk/low risk). This article reviews the recent literature regarding the prevalence of germ cell tumors in patients with DSD. Some major limitations regarding this topic, including a confusing terminology referring to the different forms of intersex disorders and unclear criteria for the diagnosis of malignant germ cells at an early age (maturation delay vs. early steps in malignant transformation) are discussed. Thereafter, an overview of the recent advances that have been made in our knowledge of germ cell tumor development and the correct diagnosis of early neoplastic lesions in this patient population is provided. A new classification system for patients with DSD is proposed as a tool to refine our insight in the prevalence of germ cell tumors in specific diagnostic groups.
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              Swyer syndrome: presentation and outcomes.

              To establish the spectrum of presentation, natural history and gynaecological outcomes in women with Swyer syndrome. Retrospective notes review. Tertiary referral centre for disorders of sex development. A total of 29 adult women with Swyer syndrome. Information was collected on age at diagnosis, biometric characteristics, timing of gonadectomy, histology of gonad, bone mineral density, uterine size and fertility. Age at diagnosis, risk of gonadal malignancy, bone mineral density, uterine size. With regard to presentation, 26/29 (90%) women in this series presented with delayed puberty, and the median age at diagnosis was 17.2 years (range 0-55 years). The median age at gonadectomy was 18 years (range 9-33 years). Histology of the gonad was available in 22 women and demonstrated streak gonads with no evidence of malignancy in 12, dysgerminoma in 7 and gonadoblastoma in 3. The youngest patient diagnosed with dysgerminoma was 10 years old. The median height of the women was 1.73 m (range 1.54-1.95 m). Twelve out of the 20 (60%) women had evidence of osteopenia on dual energy X-ray absorptiometry scan. The uterine size and shape was assessed in eight women after completion of induction of puberty, and the uterine cross-section was found to be significantly lower than that in normal controls. Fertility was achieved with ovum donation in three women, all of whom had live births and one subsequently had a second successful pregnancy. Early diagnosis of Swyer syndrome is necessary in view of the risk of dysgerminoma that can develop at an early age. Adequate hormone replacement is required to maintain bone mineral density and may improve the uterine size and shape.
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                Author and article information

                Journal
                J Korean Soc Radiol
                J Korean Soc Radiol
                JKSR
                Journal of the Korean Society of Radiology
                The Korean Society of Radiology
                2951-0805
                September 2023
                09 August 2023
                : 84
                : 5
                : 1181-1184
                Affiliations
                Department of Radiology, Changwon Fatima Hospital, Changwon, Korea. 창원파티마병원 영상의학과
                Author notes
                Corresponding author: Hyeong Gi Choi, MD. Department of Radiology, Changwon Fatima Hospital, 45 Changi-daero, Uichang-gu, Changwon 51394, Korea. Tel 82-55-270-1664, Fax 82-55-265-7766, pyunjytong@ 123456fatimahosp.co.kr
                Article
                10.3348/jksr.2023.0025
                10585094
                37869128
                87f3129d-45e8-442c-a7be-51ef48be022e
                Copyrights © 2023 The Korean Society of Radiology

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 16 March 2023
                : 21 April 2023
                : 19 May 2023
                Categories
                Genitourinary Imaging
                Case Report

                swyer syndrome,computed tomography, x-ray,karyotype
                swyer syndrome, computed tomography, x-ray, karyotype

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