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Viart L, Peltier J, Forzini T, Page C, Foulon P, Saint F, Havet E. [Persistent Müllerian ducts syndrome: one case of late hypofertility]. Morphologie 2015; 99:23-28. [PMID: 25708641 DOI: 10.1016/j.morpho.2015.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2014] [Revised: 12/16/2014] [Accepted: 01/02/2015] [Indexed: 06/04/2023]
Abstract
We report the case of a 35-year-old patient with a syndrome of persistent Müllerian ducts (PMDS) of the female type (group A). The diagnosis was made in adulthood during an infertility workup. Clinical examination revealed an empty scrotum, a normal penis and bilateral inguinal cystic masses. The spermogram found azoospermia. Imaging using MRI and tomotensidometry found the presence of an uterus, two fallopian tubes and two inguinal positions of polycystic testes. A surgical management was performed for surgical testicular biopsy. Histological examination then found a cystic formation of multi-celled mesothelial origin, with atrophic testis Sertoli cell involution and without sperm. PMDS is a rare form of pseudo-internal hermaphroditism characterized by the presence in a man of the uterus, fallopian tubes and upper vagina with external male genitalia and virilized characters. About 200 cases are reported in the literature. The diagnosis is often made in children intraoperatively during a cure of testicular ectopia. The karyotype is 46 XY type. The pathogenesis is related to a deficiency of anti-Müllerian hormone (AMH) or tissue resistance to its action by receptor abnormalities. The regression of the Müllerian duct derivatives can give three types of PMDS : masculine type, feminine type and a transverse type. Surgical treatment is difficult but necessary because of the risk of infertility and ectopic testicular degeneration.
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Affiliation(s)
- L Viart
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France; Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France.
| | - J Peltier
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - T Forzini
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France
| | - C Page
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - P Foulon
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
| | - F Saint
- Service d'urologie-transplantation, CHU Amiens-Picardie, avenue Laënnec, 80480 Salouël, France
| | - E Havet
- Laboratoire d'anatomie et d'organogenèse, UFR de médecine d'Amiens, 3, rue des Louvels, 80036 Amiens cedex 1, France
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Examination Under Anesthesia for Management of Impalpable Undescended Testis: A Traditional Technique Revisited. World J Surg 2013; 37:1125-9. [DOI: 10.1007/s00268-013-1973-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Syndrome de la persistance des canaux de Muller. AFRICAN JOURNAL OF UROLOGY 2012. [DOI: 10.1016/j.afju.2012.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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[Persistent Müllerian ducts syndrome]. Prog Urol 2010; 20:1227-9. [PMID: 21130405 DOI: 10.1016/j.purol.2010.01.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2009] [Revised: 11/16/2009] [Accepted: 01/18/2010] [Indexed: 11/21/2022]
Abstract
Persistent Müllerian ducts syndrome is a rare form of internal male pseudohermaphroditism, characterized by the presence of the uterus, fallopian tubes and upper vagina in an otherwise normally virilised male with a 46 XY karyotype. It is the result of a deficiency in anti-Müllerian hormone or abnormality of this hormone receptor. Often, the diagnosis is made incidentally during surgical exploration for cryptorchidism or herniorrhaphy, and exceptionally during cancer of ectopic testis. We discuss a rare case of this syndrome revealed by a bilateral intra-abdominal gonadal tumor.
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