Complete Androgen Insensitivity Syndrome in a Young Girl with Primary Amenorrhea and Suspected Delayed Puberty: A Case-Based Review of Clinical Management, Surgical Follow-Up, and Oncological Risk

<i>Background:</i> Complete androgen insensitivity syndrome (CAIS) is a rare disorder of sex development characterized by 46,XY karyotype and testes, yet presenting with a complete female phenotype, which is related to mutations in the androgen receptor (<i>AR</i>) gene. <...

Full description

Saved in:
Bibliographic Details
Main Authors: Barbara Fraccascia, Giorgio Sodero, Lucia Celeste Pane, Elena Malavolta, Caterina Gola, Luigi Pane, Valentina Filomena Paradiso, Lorenzo Nanni, Donato Rigante, Clelia Cipolla
Format: Article
Language:English
Published: MDPI AG 2024-10-01
Series:Diseases
Subjects:
Online Access:https://www.mdpi.com/2079-9721/12/10/235
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:<i>Background:</i> Complete androgen insensitivity syndrome (CAIS) is a rare disorder of sex development characterized by 46,XY karyotype and testes, yet presenting with a complete female phenotype, which is related to mutations in the androgen receptor (<i>AR</i>) gene. <i>Case presentation:</i> We herein present the case of a 14-year-old adolescent with primary amenorrhea and suspected delayed puberty whose diagnostic journey led to the identification of CAIS through the demonstration of a novel <i>AR</i> variant (c.159_207del). <i>Case-based review:</i> Our report encompasses the complexity of CAIS management, focusing on the risk of malignancy, surveillance options, hormone replacement therapy, timing of an eventual gonadectomy, and the psychosocial impact of such a diagnosis. An algorithm has been formulated for the management of CAIS starting in adolescence, highlighting the conservative approach for those patients unwilling to undergo gonadectomy. <i>Conclusions:</i> Primary amenorrhea and delay in puberty development may provide clues, ultimately leading to a diagnosis of CAIS. This review emphasizes the cruciality of a multidisciplinary approach in managing patients with CAIS, needing for an individualized care to optimize the overall outcome.
ISSN:2079-9721