単孔式腹腔鏡下性腺摘除術を施行したアンドロゲン不応症の1例

Abstract

A 20-year-old woman referred to our hospital for further examination of primary amenorrhea with high levels of testosterone (998 ng/ml). Inspite of having normal female external genitalia, she had 5cm deep blind-ending vagina, absence of uterus and ovaries with the karyotype of 46, XY. Abdominal magnetic resonance imaging localized bilateral intra abdominal structures, which indicated bilateral testes. Thus, she was diagnosed with androgen insensitivity syndrome(AIS) based on both clinical and karyotypic evidence. She underwent laparoscopic bilateral gonadalectomythrough a single incision at the navel and histological examination showed intratubular germ cell neoplasia (ITGCN). Her postoperative course was uneventful with less pain and a small surgical wound was onlyat the navel. Laparoendoscopic single site surgery (LESS) can be considered a surgical procedure for gonadalectomyin AIS patients.