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A case of testicular leiomyoma in androgen insensitivity syndrome: exploring malignancy controversies.

Oxf Med Case Reports

January 2025

Department of Biochemistry, Samyak Diagnostic Pvt Ltd, Yala Sadak, Kathmandu 44600, Nepal.

Testicular leiomyoma is an exceptionally rare finding in patients with androgen insensitivity syndrome (AIS). Here, we present a report of a 30-year-old individual diagnosed with complete AIS who presented with an inguinal mass subsequently identified as a right sided testicular leiomyoma. While leiomyoma are generally considered benign, controversies persist regarding the potential for malignancy in inguinal masses among AIS patients.

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Recently, the knowledge of the genetic basis of fertility disorders has expanded enormously, mainly thanks to the use of next-generation sequencing (NGS). However, the genetic cause of infertility, in the majority of patients, is still undefined. The aim was to identify novel and recurrent pathogenic/likely pathogenic variants in patients with isolated infertility or puberty delay using a targeted NGS technique.

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Androgen insensitivity syndrome (AIS) is an X-linked genetic disorder caused by mutations in the androgen receptor gene (), leading to impaired androgen signaling and resulting in varying degrees of undermasculinization in individuals with a 46,XY karyotype. This study aimed to expand the molecular landscape of AIS by identifying and characterizing pathogenic variants in the gene via next-generation sequencing (NGS). Molecular diagnostics revealed eight distinct variants within the gene, two of which had not been previously described.

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Mayer-Rokitansky-Küster-Hauser syndrome (MRKHS) is a rare congenital disorder characterized by agenesis of the uterus and upper two-thirds of the vagina. It affects around 1 in 4000-5000 females and is of two types: type 1, also known as isolated Müllerian aplasia or Rokitansky, which involves only uterovaginal agenesis, and type 2, presents as uterovaginal agenesis along with renal, cardiac, and other organ anomalies. Despite the absence of vaginal and uterine structures, individuals with MRKHS typically present with normal secondary sexual characteristics and ovarian functions.

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