無睾丸症について -1成人例の経験から-

Abstract

The patient, a 20-year old man, was admitted to the hospital for incomplete pubertal development. He was boyish in appearance and eunuchoidal without secondary sexual characteristics. His height, the length of his arm and his body weight were 172.2 cm, 79.7 cm and 70 kg, respectively. His penis was 5 cm in length and his scrotum was empty. No prostate was palpated. Chromosome analysis showed a normal male 46, XY complement. Urinary hormonal determinations revealed gonadotropins over 48 m.u.u. 17-KS 9.8 mg/day and estrogens 9.96 µg/day. An HCG-stimulation test was negative. His bone age was estimated to be about 15 years. His IVP and urethrogram were normal. By psychological tests, he showed a feminine character. Also he was noted to have escapism and a strong tendency to suicide. On exploration, his testicular vessels and vas deferens were found to terminate blindly in the middle part of the inguinal canal; a testis was not found even using histological tests. 795 With exogenous androgen therapy, the patient achieved a dramatic improvement in hoth somatic and emotional status.