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Research ArticlePROCEEDINGS OF THE 20th ANNUAL MEETING OF THE SOCIETY OF BIOTHERAPEUTIC APPROACHES, 10 December, 2016 (Fukuoka, Japan)

Laparoscopically Removed Streak Gonad Revealed Gonadoblastoma in Frasier Syndrome

KAZUNORI HASHIMOTO, YU HORIBE, JIRO EZAKI, TOSHIYUKI KANNO, NOBUKO TAKAHASHI, YOSHIKA AKIZAWA, HIDEO MATSUI, TOMOKO YAMAMOTO and NORIYUKI SHIBATA
Anticancer Research July 2017, 37 (7) 3975-3979;
KAZUNORI HASHIMOTO
1Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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  • For correspondence: hashimoto.kazunori@twmu.ac.jp
YU HORIBE
1Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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JIRO EZAKI
2Department of Pathology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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TOSHIYUKI KANNO
1Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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NOBUKO TAKAHASHI
1Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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YOSHIKA AKIZAWA
1Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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HIDEO MATSUI
1Department of Obstetrics and Gynecology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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TOMOKO YAMAMOTO
2Department of Pathology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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NORIYUKI SHIBATA
2Department of Pathology, Faculty of Medicine, Tokyo Women's Medical University, Tokyo, Japan
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Abstract

Background: Frasier syndrome (FS) is characterized by gonadal dysgenesis and progressive nephropathy caused by mutation in the Wilm's tumor gene (WT1). We report a case of FS in which diagnosis was based on amenorrhea with nephropathy, and laparoscopically-removed streak gonad which revealed gonadoblastoma. Case Report: At the age of 3 years, the patient developed nephrotic syndrome. This later became steroid-resistant and, by the age of 16 years, had progressed to end-stage renal failure with peritoneal dialysis. At the age of 17 years, the patient presented primary amenorrhea and was referred to our department. Physical examination was consistent with Tanner 1 development and external genitalia were female phenotype. Speculum examination showed uterine cervix and uterine body and bilateral ovaries were not palpable on pelvic examination. Multi-sliced computed tomography of abdomen and pelvis revealed streaked structure along the bilateral external iliac artery at pelvic wall and hypoplastic uterus. Serum testing revealed primary hypogonadism pattern, elevated follicle-stimulating hormone and luteinizing hormone with low concentrations of estradiol and testosterone. The patient underwent genetic counseling with her parents. Chromosomal status was 46XY karyotype and DNA sequencing confirmed FS due to a heterozygous WT1 mutation (IVS9+5G>A). Elective laparoscopic bilateral salpingo-oophorectomy was performed to avoid increased risk for gonadoblastoma. Pathological examination revealed gonadoblastoma in the right gonad. Conclusion: Although a rare disease, the diagnosis of FS should be considered in the case of primary amenorrhea with nephropathy. Prophylatic gonadectomy is recommended due to the high risk of gonadoblastoma in the dysgenetic gonad.

  • Fraiser syndrome
  • gonadoblastoma
  • streak gonad
  • WT1 gene mutation
  • case report
  • Received May 2, 2017.
  • Revision received May 23, 2017.
  • Accepted May 25, 2017.
  • Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved
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Anticancer Research: 37 (7)
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Laparoscopically Removed Streak Gonad Revealed Gonadoblastoma in Frasier Syndrome
KAZUNORI HASHIMOTO, YU HORIBE, JIRO EZAKI, TOSHIYUKI KANNO, NOBUKO TAKAHASHI, YOSHIKA AKIZAWA, HIDEO MATSUI, TOMOKO YAMAMOTO, NORIYUKI SHIBATA
Anticancer Research Jul 2017, 37 (7) 3975-3979;

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Laparoscopically Removed Streak Gonad Revealed Gonadoblastoma in Frasier Syndrome
KAZUNORI HASHIMOTO, YU HORIBE, JIRO EZAKI, TOSHIYUKI KANNO, NOBUKO TAKAHASHI, YOSHIKA AKIZAWA, HIDEO MATSUI, TOMOKO YAMAMOTO, NORIYUKI SHIBATA
Anticancer Research Jul 2017, 37 (7) 3975-3979;
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Show more PROCEEDINGS OF THE 20th ANNUAL MEETING OF THE SOCIETY OF BIOTHERAPEUTIC APPROACHES, 10 December, 2016 (Fukuoka, Japan)

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Keywords

  • Fraiser syndrome
  • gonadoblastoma
  • streak gonad
  • WT1 gene mutation
  • case report
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