{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T22:44:32Z","timestamp":1773787472203,"version":"3.50.1"},"reference-count":69,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T00:00:00Z","timestamp":1749686400000},"content-version":"vor","delay-in-days":162,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Case Reports in Pediatrics"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:p>\n                    <jats:bold>Background:<\/jats:bold>\n                    Ovotesticular disorder of sexual differentiation (DSD) is one of the rarest congenital conditions affecting gonadal and sexual development, characterized by the coexistence of ovarian and testicular tissue within an individual. This condition often presents with ambiguous genitalia, atypical pubertal development, or unexpected menstrual activity. This case report details a 14\u2010year\u2010old phenotypic male with ambiguous genitalia, cyclic perineal bleeding, and synchronous bilateral dysgerminoma, underscoring the diagnostic complexities and management challenges encountered in resource\u2010constrained settings.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Case Presentation:<\/jats:bold>\n                    A 14\u2010year\u2010old individual assigned male at birth and raised as a boy presented with progressive abdominal distension, cyclic perineal bleeding, and absent male secondary sexual characteristics. Physical examination revealed ambiguous genitalia, a small phallic structure, a perineal opening with menstrual blood, and no palpable gonads. Hormonal analysis revealed elevated lactate dehydrogenase and gonadotropins, low testosterone levels, and increased estradiol. Imaging revealed an abdominopelvic mass highly suggestive of ovarian malignancy, and vaginal exploration confirmed M\u00fcllerian structures. Laparotomy revealed a 16\u2010cm\u2009\u00d7\u200918\u2010cm right adnexal mass, and histopathology confirmed dysgerminoma. The patient was lost to follow\u2010up but returned 6\u2009months later with a contralateral (left) adnexal mass, prompting oncologic referral.\n                  <\/jats:p>\n                  <jats:p>\n                    <jats:bold>Conclusion:<\/jats:bold>\n                    Ovotesticular DSD with bilateral dysgerminoma is exceedingly rare and poses significant diagnostic and therapeutic challenges. Early diagnosis, multidisciplinary management, and timely oncologic intervention are crucial for optimizing patient outcomes, especially in resource\u2010limited settings. This case underscores the critical need for heightened awareness, improved access to karyotyping, genetic and hormonal assessments, and long\u2010term follow\u2010up for individuals presenting with ambiguous genitalia and atypical pubertal development.\n                  <\/jats:p>","DOI":"10.1155\/crpe\/7659991","type":"journal-article","created":{"date-parts":[[2025,6,12]],"date-time":"2025-06-12T11:09:40Z","timestamp":1749726580000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Suspected Ovotesticular Disorders of Sexual Differentiation in a Phenotypic Male With Ambiguous Genitalia, Light Menstrual Flow, and Synchronous Bilateral Dysgerminoma: A Case Report From Ethiopia"],"prefix":"10.1155","volume":"2025","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6468-7708","authenticated-orcid":false,"given":"Melkamu","family":"Siferih","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tesfaye","family":"Negasa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Muluken","family":"Yifru","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Adane","family":"Sisay","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Genetu","family":"Tadele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tajudin","family":"Adem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikias","family":"Gebrie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Worku","family":"Taye","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,12]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-clinpsy-081219-101412"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-018-0010-8"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000508153"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2021.02.105"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/NJCA.NJCA_81_23"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2017.00231"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpag.2018.09.006"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1159\/000519323"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-319-49364-0_5"},{"key":"e_1_2_13_10_2","article-title":"Women with Amenorrhea and Men with Menstruation: The Qualitative Experiences of People with Disorders of Sex Development in Nigeria","author":"Sani A.","year":"2019","journal-title":"Journal of Nursing Research"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.4158\/EP15606.OR"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1155\/2024\/9987144"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2023-061810"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.25259\/JCIS_45_2019"},{"key":"e_1_2_13_15_2","doi-asserted-by":"publisher","DOI":"10.3390\/jcm9113555"},{"key":"e_1_2_13_16_2","first-page":"110","article-title":"Endocrine Management of Ovotesticular DSD, an Index Case and Review of the Literature","volume":"17","author":"Kilberg M.","year":"2019","journal-title":"Pediatric Endocrinology Reviews"},{"key":"e_1_2_13_17_2","doi-asserted-by":"publisher","DOI":"10.3109\/09513590.2015.1116509"},{"key":"e_1_2_13_18_2","doi-asserted-by":"publisher","DOI":"10.3389\/fped.2022.856128"},{"key":"e_1_2_13_19_2","doi-asserted-by":"publisher","DOI":"10.21037\/tau.2016.08.09"},{"key":"e_1_2_13_20_2","doi-asserted-by":"publisher","DOI":"10.1530\/EJE-22-0283"},{"key":"e_1_2_13_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0040858"},{"key":"e_1_2_13_22_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph20032139"},{"key":"e_1_2_13_23_2","unstructured":"MehmoodK.andRenteaR. 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