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  #1  
Old 05-28-2011
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Question Testicular feminization question

Testicular feminization: which of the following statements regarding this syndrome is correct?

a- The testosterone level is in the male range, resulting in pubic and axillary hair
b- The gonads should not be removed until after full sexual development
c- The risk of dysgerminoma or other gonadal neoplasms is great until 20 years of age
d- Pubescence is delayed because of the absence of endogenous hormones
e- None of the above statements is true
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Old 05-28-2011
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Default ?

B)the gonads should not be removed until after they achieve full sexual development..it is removed at age 20 no?
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Old 05-28-2011
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Maybe none is true?

C is confusing a bit, but i think that the risk of cancer is not elevated if the gonads were removed early, and if they werent removed, then the risk is high for all time
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Old 05-28-2011
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C
there is no pubic&axillary hair &The testosterone level is in the male range
tested removed at age 20
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Old 05-28-2011
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is removing testes at age of 20 mandatory? couldnt we remove them before that time?!
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Old 05-28-2011
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Correct Answer Correct answer

Correct answer is B)

Orchidectomy is recommended to avoid malignant change within the intraabdominal testis, but the surgery is usually deferred because such malignancy is quite uncommon before puberty. Delaying surgery until after puberty allows endogenous estrogen to engender secondary sex characteristics in the patient. The risk of malignancy in testicular feminization is estimated to be 5%, and the malignancy typically occurs at a later age than with other intersex disorders. However, the risk of malignant transformation increases for patients older than 30 years, reaching 33% in patients older than 50 years.
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Old 05-28-2011
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Quote:
Originally Posted by bebix View Post
Correct answer is B)

Orchidectomy is recommended to avoid malignant change within the intraabdominal testis, but the surgery is usually deferred because such malignancy is quite uncommon before puberty. Delaying surgery until after puberty allows endogenous estrogen to engender secondary sex characteristics in the patient. The risk of malignancy in testicular feminization is estimated to be 5%, and the malignancy typically occurs at a later age than with other intersex disorders. However, the risk of malignant transformation increases for patients older than 30 years, reaching 33% in patients older than 50 years.
source plz for this answer ??
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  #8  
Old 05-28-2011
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Sorry....of course...

I just upload 2 for now.

Fertility and Sterility
Volume 94, Issue 1, June 2010, Pages 105-113
Care of women with XY karyotype: a clinical practice guideline
full text: ref_1.pdf

AJR 2002; 178:1496-1498
Stromal Tumor of the Sex Cord in a Woman with Testicular Feminization Syndrome
full text: ref_2.pdf

and also UpToDate.

btw...this was the actual explanation from the book, but I think it was incomplete, that way I added more information.
Answer: B. One of the entities with normal chromosomes in the group of disease characterized by gonadal dysgenesis is the XY gonad found in the testicular feminization syndrome. That gonad has a much lower malignant potential than the dysgenetic gonad with Y material and abnormal chromosomes. Pubescence occurs normally in these patients so they should not have their gonads removed until after sexual development has occurred.

Last edited by bebix; 05-28-2011 at 02:38 PM. Reason: more info.
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Old 01-14-2012
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This article from Medscape adds to bebix,s explanations and references on explaining this HY concept

http://www.medscape.com/viewarticle/517754
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Tags
Embryology-, Endocrine-, Pathology-, Reproductive-, Step-1-Questions, Syndromes-Acronyms

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