{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T16:35:19Z","timestamp":1753893319569,"version":"3.41.2"},"reference-count":24,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T00:00:00Z","timestamp":1733875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Surg."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Ovotesticular disorder of sex development is a rare form of disorder of sex development that manifests as ovotestis in individuals. The precise diagnosis and the choice of surgical procedures are still in conflict condition due to the rarity of the disease, diverse clinical presentations, and the lack of evidence-based medical studies on postoperative outcomes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>We present a 46, XX ovotesticular disorder of sex development case, aged 19, with Prader stage IV virilization who underwent feminizing genitoplasty surgery. Our surgical strategy prioritized the patient's genitourinary function restoration and cosmetic reconstruction achieved satisfactory results. We attribute the success of the treatment to the systematic diagnostic process and individualized surgical planning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The purpose of this article is to provide an evaluation protocol for the ovotesticular disorder of sex development, improving the diagnostic rate and providing some fresh ideas for surgical management.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fsurg.2024.1502340","type":"journal-article","created":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T06:58:17Z","timestamp":1733900297000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Diagnosis and surgical decision-making of a 46, XX ovotesticular disorders of sex development patient: a case report"],"prefix":"10.3389","volume":"11","author":[{"given":"Hanxing","family":"Zhao","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhixing","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Baoyun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenyu","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhengyong","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,12,11]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"151","DOI":"10.1002\/(SICI)1520-6300(200003\/04)12:2%3C151::AID-AJHB1%3E3.0.CO;2-F","article-title":"How sexually dimorphic are we? Review and synthesis","volume":"12","author":"Blackless","year":"2000","journal-title":"Am J Hum Biol"},{"key":"B2","doi-asserted-by":"publisher","first-page":"554","DOI":"10.1136\/adc.2006.098319","article-title":"Consensus statement on management of intersex disorders","volume":"91","author":"Hughes","year":"2006","journal-title":"Arch Dis Child"},{"key":"B3","doi-asserted-by":"publisher","first-page":"401","DOI":"10.1136\/adc.2002.011312","article-title":"Brain, early assessment of ambiguous genitalia","volume":"89","author":"Ogilvy-Stuart","year":"2004","journal-title":"Arch Dis Child"},{"key":"B4","doi-asserted-by":"publisher","first-page":"520","DOI":"10.1038\/nrendo.2014.108","article-title":"Management of disorders of sex development","volume":"10","author":"Hiort","year":"2014","journal-title":"Nat Rev Endocrinol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"307","DOI":"10.1159\/000466693","article-title":"The spectrum of ovotesticular disorders of sex development in South Africa: a single-centre experience","volume":"87","author":"Ganie","year":"2017","journal-title":"Horm Res Paediatr"},{"key":"B6","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1016\/j.jpurol.2013.10.023","article-title":"The ESPU\/SPU standpoint on the surgical management of disorders of sex development (DSD)","volume":"10","author":"Mouriquand","year":"2014","journal-title":"J Pediatr Urol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"231","DOI":"10.6065\/apem.2019.24.4.231","article-title":"Pubertal outcomes and sex of rearing of patients with ovotesticular disorder of sex development and mixed gonadal dysgenesis","volume":"24","author":"Kim","year":"2019","journal-title":"Ann Pediatr Endocrinol Metab"},{"key":"B8","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1016\/j.juro.2006.10.003","article-title":"The long-term follow-up of 33 cases of true hermaphroditism: a 40-year experience with conservative gonadal surgery","volume":"177","author":"Verkauskas","year":"2007","journal-title":"J Urol"},{"key":"B9","doi-asserted-by":"publisher","first-page":"203","DOI":"10.1055\/s-0029-1233490","article-title":"Congenital adrenal hyperplasia: a critical appraisal of the evolution of feminizing genitoplasty and the controversies surrounding gender reassignment","volume":"19","author":"Braga","year":"2009","journal-title":"Eur J Pediatr Surg"},{"key":"B10","doi-asserted-by":"publisher","first-page":"1103","DOI":"10.1016\/j.jpurol.2013.03.013","article-title":"Current practice in feminizing surgery for congenital adrenal hyperplasia; a specialist survey","volume":"9","author":"Yankovic","year":"2013","journal-title":"J Pediatr Urol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"265e","DOI":"10.1097\/PRS.0000000000003544","article-title":"Facial assessment and injection guide for botulinum toxin and injectable hyaluronic acid fillers: focus on the upper face","volume":"140","author":"de Maio","year":"2017","journal-title":"Plast Reconstr Surg"},{"key":"B12","doi-asserted-by":"publisher","first-page":"738","DOI":"10.1016\/s0022-3476(94)70067-2","article-title":"True hermaphroditism: genetic variants and clinical management","volume":"125","author":"Hadjiathanasiou","year":"1994","journal-title":"J Pediatr"},{"key":"B13","doi-asserted-by":"publisher","first-page":"930","DOI":"10.1038\/nature06944","article-title":"Sex determination involves synergistic action of SRY and SF1 on a specific Sox9 enhancer","volume":"453","author":"Sekido","year":"2008","journal-title":"Nature"},{"key":"B14","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/genes12040486","article-title":"Diverse regulation but conserved function: sOX9 in vertebrate sex determination","volume":"12","author":"Vining","year":"2021","journal-title":"Genes (Basel)"},{"key":"B15","doi-asserted-by":"publisher","first-page":"487","DOI":"10.1016\/j.ajhg.2018.01.021","article-title":"Loss of function of the nuclear receptor NR2F2, encoding COUP-TF2, causes testis development and cardiac defects in 46,XX children","volume":"102","author":"Bashamboo","year":"2018","journal-title":"Am J Hum Genet"},{"key":"B16","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1002\/humu.23116","article-title":"Identical NR5A1 missense mutations in two unrelated 46,XX individuals with testicular tissues","volume":"38","author":"Igarashi","year":"2017","journal-title":"Hum Mutat"},{"key":"B17","doi-asserted-by":"publisher","first-page":"3446","DOI":"10.1093\/hmg\/ddw186","article-title":"A recurrent p.Arg92Trp variant in steroidogenic factor-1 (NR5A1) can act as a molecular switch in human sex development","volume":"25","author":"Bashamboo","year":"2016","journal-title":"Hum Mol Genet"},{"key":"B18","doi-asserted-by":"publisher","first-page":"17455057231223716","DOI":"10.1177\/17455057231223716","article-title":"Maintaining vulvar, vaginal and perineal health: clinical considerations","volume":"20","author":"Graziottin","year":"2024","journal-title":"Womens Health (Lond)"},{"key":"B19","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1002\/bdrc.21147","article-title":"Challenges in the diagnosis and management of disorders of sex development","volume":"108","author":"Kutney","year":"2016","journal-title":"Birth Defects Res C Embryo Today"},{"key":"B20","doi-asserted-by":"publisher","first-page":"808","DOI":"10.1016\/j.jpedsurg.2017.08.014","article-title":"Total urogenital sinus mobilization for ambiguous genitalia","volume":"53","author":"Jesus","year":"2018","journal-title":"J Pediatr Surg"},{"key":"B21","doi-asserted-by":"publisher","first-page":"1","DOI":"10.3390\/jcm8040533","article-title":"Thrombin preconditioning of extracellular vesicles derived from mesenchymal stem cells accelerates cutaneous wound healing by boosting their biogenesis and enriching cargo content","volume":"8","author":"Sung","year":"2019","journal-title":"J Clin Med"},{"key":"B22","doi-asserted-by":"publisher","first-page":"391","DOI":"10.1016\/j.jsxm.2020.09.014","article-title":"A single-center study comparison of two different male-to-female penile skin inversion vaginoplasty techniques and their 3.5-year outcomes","volume":"18","author":"Fakin","year":"2021","journal-title":"J Sex Med"},{"key":"B23","doi-asserted-by":"publisher","first-page":"2030","DOI":"10.1016\/j.jsxm.2019.09.007","article-title":"Colic-based transplant in sexual reassignment surgery: functional outcomes and complications in 43 consecutive patients","volume":"16","author":"di Summa","year":"2019","journal-title":"J Sex Med"},{"key":"B24","doi-asserted-by":"publisher","first-page":"611.e1","DOI":"10.1016\/j.jpurol.2022.07.007","article-title":"45 years\u2019 experience with early childhood anatomical technique of feminising genitoplasty for 46 XX congenital adrenal hyperplasia -observations of vaginal introital anatomy and its relationship to the perineal body","volume":"18","author":"Hennayake","year":"2022","journal-title":"J Pediatr Urol"}],"container-title":["Frontiers in Surgery"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2024.1502340\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,12,11]],"date-time":"2024-12-11T06:58:21Z","timestamp":1733900301000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fsurg.2024.1502340\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,11]]},"references-count":24,"alternative-id":["10.3389\/fsurg.2024.1502340"],"URL":"https:\/\/doi.org\/10.3389\/fsurg.2024.1502340","relation":{},"ISSN":["2296-875X"],"issn-type":[{"type":"electronic","value":"2296-875X"}],"subject":[],"published":{"date-parts":[[2024,12,11]]},"article-number":"1502340"}}