Presentation
Married patient with a history of neglected primary amenorrhea
Patient Data
The uterus is small in size (hypoplastic uterus). The upper vagina is distended with fluid content of low signal intensity on T1WI, T2WI and gradient echo (hematocolpos, chronic phase). The sequences with vaginal filling show an opacification of the lower third only, most likely due to a transverse vaginal septum at the junction middle/lower thirds.
Both ovaries are well-visualized, containing small follicles.
Note two oval structures well-visualized in the paravesical regions, mainly on coronal T2WI, of intermediate signal intensity on T1WI and T2WI, measuring 24 x 9 mm on the right and 20 x 11 mm on the left side, highly suggestive of testes.
Case Discussion
True hermaphroditism is considered as the presence of both ovarian and testicular tissues in a single individual 1. It may be in the same gonad (ovotestis) or separate gonads. The karyotypes found in this condition are: 80% (46 XX), 10% (46XY), and 10% (mosaicism) 2.
Additional contributors: R Bouguelaa, MD and A Ramdani, MD
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