Abstract
Swyer syndrome is a rare congenital condition that serves as a risk factor for developing germ cell tumors. The condition belongs to the group of 46, XY disorders of sexual development, is characterized by complete gonadal dysgenesis (CGD) and is mostly manifested as delayed puberty and primary amenorrhea during adolescence. Individuals with Swyer syndrome are known to be phenotypically female with normal internal and external female genitalia at birth. 46, XY GD involves a high risk of gonadoblastoma development with malignant potential such that the onset is greatest at or after the event of puberty. This report of a 12-year-old phenotypic female with 46, XY GD, who developed an advanced metastatic seminoma, highlights the rarity of the development of a seminoma in the context of 46, XY CGD.
Keywords: Seminoma, Swyer syndrome, gonadal dysgenesis, 46, XY
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References
Bashamboo A, McElreavey K. Mechanism of Sex Determination in Humans: Insights from Disorders of Sex Development. Sex Dev. 2016;10:313-325. Epub 2016 Dec 3
Neocleous V, Fanis P, Cinarli F, Kokotsis V, Oulas A, Toumba M, Spyrou GM, Phylactou LA, Skordis N. 46,XY complete gonadal dysgenesis in a familial case with a rare mutation in the desert hedgehog (DHH) gene. Hormones (Athens). 2019;18:315-320. Epub 2019 Jun 25
Elzaiat M, McElreavey K, Bashamboo A. Genetics of 46,XY gonadal dysgenesis. Best Pract Res Clin Endocrinol Metab. 2022;36:101633. Epub 2022 Feb 25
Hughes IA, Houk C, Ahmed SF, Lee PA; LWPES Consensus Group; ESPE Consensus Group. Consensus statement on management of intersex disorders. Arch Dis Child. 2006;91:554-563. Epub 2006 Apr 19
Galli-Tsinopoulou A, Serbis A, Kotanidou EP, Litou E, Dokousli V, Mouzaki K, Fanis P, Neocleous V, Skordis N. 46,XY Disorder of Sex Development due to 17-Beta Hydroxysteroid Dehydrogenase Type 3 Deficiency in an Infant of Greek Origin. J Clin Res Pediatr Endocrinol. 2018;10:74-78. Epub 2017 Jul 24
Swyer GI. Male pseudohermaphroditism: a hitherto undescribed form. Br Med J. 1955;2:709-712.
Bumbulienė Ž, Varytė G, Geimanaitė L. Dysgerminoma in a Prepubertal Girl with Complete 46XY Gonadal Dysgenesis: Case Report and Review of the Literature. J Pediatr Adolesc Gynecol. 2020;33:599-601. Epub 2020 May 5
Lu L, Luo F, Wang X. Gonadal tumor risk in pediatric and adolescent phenotypic females with disorders of sex development and Y chromosomal constitution with different genetic etiologies. Front Pediatr. 2022;10:856128.
Alam S, Boro H, Goyal A, Khadgawat R. 46, XY complete gonadal dysgenesis with pubertal virilisation due to dysgerminoma/gonadoblastoma. BMJ Case Rep. 2020;13:e235501.
Piazza MJ, Urbanetz AA. Germ Cell Tumors in Dysgenetic Gonads. Clinics (Sao Paulo). 2019;74:e408.
de la Calle CM, Kim S, Baskin LS. Diagnosis and treatment of the intra-abdominal gonad in the pediatric population: Testes, ovaries, dysgenetic gonads, streaks, and ovotestes. J Pediatr Surg. 2020;55:2480-2491. Epub 2020 Feb 19
McCann-Crosby B, Mansouri R, Dietrich JE, McCullough LB, Sutton VR, Austin EG, Schlomer B, Roth DR, Karaviti L, Gunn S, Hicks MJ, Macias CG. State of the art review in gonadal dysgenesis: challenges in diagnosis and management. Int J Pediatr Endocrinol. 2014;2014:4. Epub 2014 Apr 14
Fallat ME, Donahoe PK. Intersex genetic anomalies with malignant potential. Curr Opin Pediatr. 2006;18:305-311.
Albers P, Albrecht W, Algaba F, Bokemeyer C, Cohn-Cedermark G, Fizazi K, Horwich A, Laguna MP; European Association of Urology. EAU guidelines on testicular cancer: 2011 update. Eur Urol. 2011;60:304-319. Epub 2011 May 25
Jung ES, Choi KW, Kim SW, Hübenthal M, Mucha S, Park J, Park Z, Ellinghaus D, Schreiber S, Franke A, Oh WY, Cheon JH. ZNF133 is associated with infliximab responsiveness in patients with inflammatory bowel diseases. J Gastroenterol Hepatol. 2019;34:1727-1735. Epub 2019 Apr 1
Vahedi K, Alamowitch S. Clinical spectrum of type IV collagen (COL4A1) mutations: a novel genetic multisystem disease. Curr Opin Neurol. 2011;24:63-68.
Jäger RJ, Anvret M, Hall K, Scherer G. A human XY female with a frame shift mutation in the candidate testis-determining gene SRY. Nature. 1990;348:452-454.
Hanlon AJ, Kimble RM. Incidental gonadal tumors at the time of gonadectomy in women with Swyer syndrome: a case series. J Pediatr Adolesc Gynecol. 2015;28:27-29. Epub 2014 Aug 12
Page DC. Hypothesis: a Y-chromosomal gene causes gonadoblastoma in dysgenetic gonads. Development. 1987;101(Suppl):151-155.
Jakovleva A, Kovalova Z. Complete gonadal dysgenesis analysis in the population of Latvia: malignant outcomes and a review of literature. Med Pharm Rep. 2022;95:47-53. Epub 2022 Jan 31
Jonson AL, Geller MA, Dickson EL. Gonadal dysgenesis and gynecologic cancer. Obstet Gynecol. 2010;116(Suppl 2):550-552.
Manecksha RP, Fitzpatrick JM. Epidemiology of testicular cancer. BJU Int. 2009;104:1329-1333.
Chen Z, Wei Z, Zhao W, Wang J, Shen G, He C, Chen Y. Swyer syndrome with seminoma: laparoscopic bilateral gonad resection. J Minim Invasive Gynecol. 2015;22:532-533. Epub 2014 Nov 6
Slowikowska-Hilczer J, Szarras-Czapnik M, Duranteau L, Rapp M, Walczak-Jedrzejowska R, Marchlewska K, Oszukowska E, Nordenstrom A; dsd-LIFE group. Risk of gonadal neoplasia in patients with disorders/differences of sex development. Cancer Epidemiol. 2020;69:101800. Epub 2020 Sep 6
Anwar A, Akhtar M, Busby G. Swyer Syndrome: A Case of Dysgerminoma Solely within the Fallopian Tube. J Pediatr Adolesc Gynecol. 2021;34:869-871. Epub 2021 May 11
Arafa M, Ryiami MA, Shukri MA, Burney I, Mahfouz Y, Al-Kindi N. Bilateral Gonadoblastoma Overgrown by Dysgerminoma of the Right Gonad in a Patient with Swyer Syndrome. Maedica (Bucur). 2021;16:734-737.
Behtash N, Karimi Zarchi M. Dysgerminoma in three patients with Swyer syndrome. World J Surg Oncol. 2007;5:71.
Ben Temime R, Chachial A, Attial L, Ghodbanel I, Makhloufl T, Koubaal A, Kourda N, Ben Jilani S, Dammak T, El May A, Rahal K. 46 XY pure gonadal dysgenesis with gonadoblastoma and dysgerminoma. Tunis Med. 2008;86:710-713.
Bjersing L, Kjellgren O. Dysgerminomas (seminomas) in genetic males with female phenotype. One case of gonadal dysgenesis and gonadoblastoma and one of testicular feminization. Acta Obstet Gynecol Scand Suppl. 1977;66:27-37.
Çatlı G, Alparslan C, Can PŞ, Akbay S, Kelekçi S, Atik T, Özyılmaz B, Dündar BN. An Unusual Presentation of 46,XY Pure Gonadal Dysgenesis: Spontaneous Breast Development and Menstruation. J Clin Res Pediatr Endocrinol. 2015;7:159-162.
Dural O, Evruke I, Can S, Yasa C, Ugurlucan FG, Akhan SE. Atypical Presentation of Swyer Syndrome. J Pediatr Adolesc Gynecol. 2019;32:645-647. Epub 2019 Jul 26
Gonzalez-Benitez C, De La Iglesia E, De Santiago J, Zapardiel I. Dysgerminoma on a gonadoblastoma in a patient with Swyer syndrome treated with single incision laparoscopic surgery. J Obstet Gynaecol. 2015;35:102-103. Epub 2014 Jun 24
Hamed ST, Hanafy MAM. Swyer syndrome with malignant germ cell tumor: a case report. Egypt J Radiol Nucl Med. 2021;52:239.
Han Y, Wang Y, Li Q, Dai S, He A, Wang E. Dysgerminoma in a case of 46, XY pure gonadal dysgenesis (Swyer syndrome): a case report. Diagn Pathol. 2011;6:84.
Ilter E, Haliloğlu B, Akin FT, Karaman A, Ozden S. Pure 46,XY gonadal dysgenesis (Swyer syndrome) with breast development and secondary amenorrhea. Gynecol Obstet Invest. 2008;66:214-216. Epub 2008 Jul 22
Jadhav MN, Yelikar BR, Karigoudar M. Gonadoblastoma with contralateral dysgerminoma in a young female--a case report. Indian J Pathol Microbiol. 2006;49:274-276.
Kim SK, Sohn IS, Kim JW, Song CH, Park CI, Lee MS, Kim GW, Kim KR. Gonadoblastoma and dysgerminoma associated with 46,XY pure gonadal dysgenesis--a case report. J Korean Med Sci. 1993;8:380-384.
Kumar NP, M V, Mathews A, James FV. Mixed Germ Cell Tumour in a Case of Pure Gonadal Dysgenesis (Swyer Syndrome) - A Case Report. Cureus. 2016;8:459.
Milewicz T, Mrozińska S, Szczepański W, Białas M, Kiałka M, Doroszewska K, Kabzińska-Turek M, Wojtyś A, Ludwin A, Chmura Ł. Dysgerminoma and gonadoblastoma in the course of Swyer syndrome. Pol J Pathol. 2016;67:411-414.
Stachowicz-Stencel T, Synakiewicz A, Iżycka-Świeszewska E, Kobierska-Gulida G, Balcerska A. Malignant germ cell tumors associated with Swyer syndrome. Pediatr Blood Cancer. 2011;56:482-483. Epub 2010 Nov 15
Yada-Hashimoto N, Komura H, Nagata S, Kubo C, Fujita M, Kamiura S. Unexpected diagnosis of stage IIA dysgerminoma in streak gonad in a patient with Swyer syndrome: a case report. Gynecol Endocrinol. 2018;34:464-466. Epub 2017 Oct 31
Zhu J, Liu X, Jin H, Lu X. Swyer syndrome, 46,XY gonadal dysgenesis, a sex reversal disorder with dysgerminoma: a case report and literature review. Clin Exp Obstet Gynecol. 2011;38:414-418.
Zhu HL, Bao DM, Wang Y, Shen DH, Li Y, Cui H. Swyer’s Syndrome with Mixed Ovarian Malignant Germ Cell Tumor and Ovarian Gonadoblastoma. Chin Med J (Engl). 2016;129:1752-1754.


