Abstract
The risk of gonadal neoplasia among patients with dysgenetic gonads is high, thus dictating early removal of dysgenetic gonads. Laparoscopic surgery has quickly become the standard of prophylactic gonadectomy, because of small incisions resulting in reduced pain and shorter hospital stay. For malignancies, however, port site metastasis and a higher incidence of intraoperative tumor rupture represent possible risks associated with laparoscopic surgery. Here we report a 16-year-old, phenotype female patient with a 46XY karyotype that underwent prophylactic gonadectomy by laparoscopic procedures. Preoperative MRI revealed immature uterus and steak gonads without any evidence of gonadal neoplasia. Resected gonads also appeared macroscopically normal. However, the pathologic diagnosis of bilateral gonads was raptured gonadoblastomas. Because 20-30% of gonadoblastoma is reported to be a microscopic tumor, laparoscopic surgery for prophylactic removal of dysgenetic gonads should be carefully performed.
