Endocrine Abstracts

23 yr old male reviewed in endocrine clinic due to Severe Gynecomastia. He was born of the consanguineous parents. His milestones were normal. He had bilateral undescended testes and a very complicated penoscrotal transposition penile urethral meatus. He had bilateral orchidopexy and hypospadias repair by paediatric surgeon at the age of 9. He achieved puberty at 14 yrs and started shaving around 17 yrs. On examination his Height was 179 cm, weight 78.2 kg, with BMI of 24.41 kg/m². He had normal secondary sexual characteristics. The right testicle was small and left testicle hardly felt. He had gynaecomastia. He had XY karyotype. His blood results showed Testosterone 26.2 nmol/l, FSH 7.7 zzIU/l, and LH 21.4 zzIU/l. He had normal TSH 1.26 mu/l, Cortisol 343 nmol/l, IGF1 40.6 nmol/l, and Prolactin 315 mu/l. His Androstenedione was 4.8 nmol/l, Dihydrotestosterone 1.04 nmol/l, and Pre-stimulated T/DHT ratio 20.01. HCG stimulation test showed post stimulation testosterone 34.6 nmol/l, DHT 1.42 nmol/l, T/DHT ratio >20. US urinary tract showed Posterior to the bladder there are some hypoechoic structures which are possibly seminal vesicles, The prostate is not well delineated but appears small and measures ~6 ml, which suggested the possibility of Partial Androgen insensitivity syndrome. He had a genetic analysis and this confirmed the diagnosis of AR-related androgen insensitivity, He had breast reduction surgery