OBJECTIVE: Adult women with complete androgen insensitivity syndrome (CAIS) are increasingly likely to defer or decline gonadectomy despite counselling about malignancy risk. The objectives of this study were to review the evidence on the risk of gonadal malignancy in adult women with CAIS and to explore women's reasons for deferring gonadectomy. STUDY DESIGN: A case series and literature review. PATIENTS: Sixteen women with CAIS over the age of 18 years who have elected to defer gonadectomy. RESULTS: Sixty-two relevant papers were identified. Of these, 14 confirmed that tumours had been reported in 98 adults. Taking into account the limitations of combining historic case series, this review estimates a risk of gonadal malignancy of 14% (range 0% and 22%) in adults with CAIS. The most common reasons women offered for deferring gonadectomy included inconvenience of surgery, concern about surgical risk and reluctance to take hormone replacement therapy. CONCLUSIONS: Perceived benefits for retaining gonads in women with CAIS are prompting more women to keep their gonads in situ. An accurate estimate for adult malignancy risk is unavailable, and the risks currently quoted may be falsely reassuring.
OBJECTIVE: Adult women with complete androgen insensitivity syndrome (CAIS) are increasingly likely to defer or decline gonadectomy despite counselling about malignancy risk. The objectives of this study were to review the evidence on the risk of gonadal malignancy in adult women with CAIS and to explore women's reasons for deferring gonadectomy. STUDY DESIGN: A case series and literature review. PATIENTS: Sixteen women with CAIS over the age of 18 years who have elected to defer gonadectomy. RESULTS: Sixty-two relevant papers were identified. Of these, 14 confirmed that tumours had been reported in 98 adults. Taking into account the limitations of combining historic case series, this review estimates a risk of gonadal malignancy of 14% (range 0% and 22%) in adults with CAIS. The most common reasons women offered for deferring gonadectomy included inconvenience of surgery, concern about surgical risk and reluctance to take hormone replacement therapy. CONCLUSIONS: Perceived benefits for retaining gonads in women with CAIS are prompting more women to keep their gonads in situ. An accurate estimate for adult malignancy risk is unavailable, and the risks currently quoted may be falsely reassuring.
Authors: Erica M Weidler; Maria E Linnaus; Arlene B Baratz; Luis F Goncalves; Smita Bailey; S Janett Hernandez; Veronica Gomez-Lobo; Kathleen van Leeuwen Journal: J Pediatr Adolesc Gynecol Date: 2019-06-21 Impact factor: 1.814
Authors: Michael H Hsieh; Hadley M Wood; Brad E Dicianno; Nienke P Dosa; Veronica Gomez-Lobo; Tej K Mattoo; Rosalia Misseri; Jenna M Norton; Kathleen J Sawin; Peter Scal; James E Wright; Robert A Star; Tamara Bavendam Journal: Urology Date: 2017-02-02 Impact factor: 2.649
Authors: Eun Jung Jung; Do Hwa Im; Yong Hee Park; Jung Mi Byun; Young Nam Kim; Dae Hoon Jeong; Moon Su Sung; Ki Tae Kim; Hyo Jung An; Soo Jin Jung; Kyung Bok Lee Journal: Obstet Gynecol Sci Date: 2017-07-14