Fróðskaparrit - 01.01.1965, Page 96

104
True Hermaphroditism
to the hospital the patient was found to be delicately
built with a feminine distribution of the subcutaneous fat.
The pubes was of feminine demarcation and the hair on the
body was very sparse. The growth of beard was very thin
with a few fair, thin stubbles. The patient had well-developed
mammae as in a woman. (Fig. 2). His voice was as a boy’s at
puberty. Mentally he seemed a normal male. He had marked
genu valgum, but there was no cubitus valgus or pterygium colli.
The penis was found to be 4 cm of length and there was a
slight hypospadias. On the first examination two small intumes-
cences were found in the left side of the otherwise normal
scrotal sack, while the right side was empty. No indications of
heart, aorta or kidney abnormities were found by usual somatic
and x-ray examinations. Urethroscopy or urethrografy were not
performed. The excretion in urine of 17-ketosteroids and 17-keto-
genic steroids was normal. Only these hormon analysis were per-
formed. During the operation for acute appendicitis a muscular
organ was found in the left side of the abdomen resembling an
uterus. Upwards and laterally from this organ an one cm thick
string was found disappearing through canalis ingvinalis together
with the spermatic cord, which easily could be separated from
the former tissue. This was interpreted as Miiller’s duct, and no
further action was taken and the abdomen closed.
During the following years the patient complained of distress
caused by an ingvinal hernia on the left side, and at 66 years
of age he was readmitted to the hospital with incarcerated left
ingvinal hernia. During the operation a ligamentum latum re-
semling structure was found in the hernial sack, covered by
peritoneum on both sides. (Fig. 3). In this structure there was
felt a pear-shaped intumescens with fundus towards an ovarian-
resembling tissue, which apparently showed scars from ovulations.
This structure was removed for histologic examination.
The microscopic examination showed the ovarian-resembling
structure to be an ovotestis. The pear-shaped structure consisted
of a thick muscular wall with a narrow central duct covered
with mucosal tissue resembling endometrial tissue. This organ
consequently could be an uterus. The microscopic examination of
the tissue on the other side of the ovotestis, where macroscopi-
cally a little epoophoronic structure and a 4 cm long tuba
-resembling structure with fimbriae could be distinguished, showed
an epididymis-resembling structure. Besides this a duct quite
resembling ductus deferens was found. There was no signs of
spermatozoa. Further a small uncharacteristic duct was seen,