Successful treatment of an intersex patient with cryptorchidism

On May 30, Dr. Tran Trong Tri, Department of Urology, Cho Ray Hospital, said that this place had just successfully treated patient A. (40 years old, living in Dong Nai), a mosaic intersex patient with hidden testicular cancer.

This is considered the first case of intersex with mosaic chromosome set 46, XX/46, XY with testicular cancer detected and treated with surgery and chemotherapy at Cho Ray Hospital.

The family said that when the patient was 3 years old, they discovered that he had a left testicle in the left inguinal canal, so they took him to a children's hospital for examination. He was then discharged and has not had any further examinations or interventions since then. The patient has a female appearance and has never had a period.

Điều trị thành công cho 1 bệnh nhân lưỡng giới bị ung thư tinh hoàn - Ảnh 1. — Doctor examining and consulting intersex patient

Recently, the patient noticed that the left groin area began to grow larger and more painful, so he went to the local hospital for examination and was then transferred to Cho Ray Hospital. The results of the general examination showed that the patient's chest was not developed; the clitoris was enlarged, with labia majora on both sides; there was no vagina; no menstruation, and the external urethral opening was normal. The patient had a mass in the left groin area of about 5 x 8 cm, with a firm density, not mobile, and little pain when pressed.

Assessing this as an extremely rare case, the treatment team held a multidisciplinary consultation and decided to perform surgery to remove the left testicular tumor.

During surgery, the team discovered that the patient still had a right ovary and no uterus. The pathological results were seminoma (a type of germ cell cancer in the testicles, commonly found in young men).

According to Dr. CK.2 Vuong Dinh Thy Hao, Head of the Chemotherapy Department at Cho Ray Hospital, after surgery, the patient received 6 cycles of supportive chemotherapy and responded well to all of them. Although the patient was admitted to the hospital late for treatment, fortunately, he was diagnosed, had surgery, and received chemotherapy successfully.

According to Dr. Thy Hao, testicular cancer is very common in cases where the testicles are hidden in the abdomen, especially in cases of gender disorders such as having two genital organs on the same body. Dr. Thy Hao also recommends that if anyone is unfortunately in this situation, do not hesitate, go to a medical facility with a urology department for timely examination, testing, and evaluation to avoid possible serious consequences, especially the very high risk of cancer in cases of hidden testicles in the abdomen.

According to Dr. Tran Trong Tri, mosaic hermaphroditism is a disorder of sex differentiation characterized by the simultaneous presence of male and female genitalia in the same individual, occurring in 1/100,000 live births. Mosaic hermaphroditism is a very rare abnormality.

Mosaicism is thought to result from fusion of a fertilized egg with its polar body, binucleation, or double fertilization. The first case of mosaicism was reported in 1962 with true hermaphrodites, one ovary and one hermaphrodite gonad. To date, there have been over 50 documented cases of true hermaphrodites and tumors in true hermaphrodites have been reported in less than 10 cases.

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