Navigating Ambiguous Genitalia: A Case of Dysgerminoma in an Afghan Boy.

Abstract

Introduction: Ambiguous genitalia (AG) present significant challenges in both diagnosis and management. Often associated with disorders of sexual development (DSD), AG can lead to complex medical scenarios, including an increased risk of malignant transformation. This case report underscores the importance of recognizing the clinical implications of AG and the necessity for careful monitoring.

Case presentation: We present the case of a 22-year-old male who presented with abdominal pain and distension. Upon physical examination, he exhibited characteristics consistent with ambiguous genitalia, including a small penis and an absent scrotal sac. The diagnostic imaging, particularly computed tomography (CT) scans, revealed a large solid mass in the left adnexa. This mass displayed lobulated outlines and speckled calcifications, which raised concerns for a potentially malignant process. Given the findings, the patient underwent surgical intervention, which included a total abdominal hysterectomy, bilateral salpingo-oophorectomy, and omentectomy to ensure complete removal of the tumor and surrounding affected tissues. Histopathological analysis of the excised tissue confirmed the diagnosis of dysgerminoma, a type of germ cell tumor known for its malignant potential.

Conclusion: This case highlights the critical need for vigilant surveillance for malignancy in patients with ambiguous genitalia. The inherent risk factors associated with AG necessitate a proactive approach to patient management, including regular imaging and timely surgical interventions. By adopting a comprehensive care strategy, healthcare providers can optimize patient outcomes and address the unique challenges posed by disorders of sexual development. Continuous monitoring and early intervention are paramount in mitigating the risks of tumor development in this vulnerable demographic.