True hermaphroditism presenting as bilateral gynecomastia in an adolescent phenotypic male.

OBJECTIVE: To report a rare case of true hermaphroditism presenting in adolescence as bilateral gynecomastia in a phenotypic male.

DESIGN: Case report.

SETTING: Academic medical center.

PATIENT(S): A 19-year-old phenotypic male who presented with pronounced bilateral gynecomastia and was ultimately diagnosed with true hermaphroditism.

INTERVENTION(S): Endoscopic removal of the internal female genital tract (hemiuterus and ovary), reduction mammoplasty, repair of penile chordee, and left testicular prosthesis placement.

MAIN OUTCOME MEASURE(S): Diagnosis and treatment of true hermaphroditism.

RESULT(S): Bilateral mammoplasties, repair of a penile chordee, placement of a left testicular prosthesis, and excision of the left hemiuterus and ovary resulted in return to testicular function in this true hermaphrodite.

CONCLUSION(S): Although rare, true hermaphroditism should be suspected in male patients presenting with bilateral breast enlargement in adolescence.