Case report
Gynecologic malignancies in female-to-male transgender patients: the need of original gender surveillance

https://doi.org/10.1016/j.ajog.2010.12.057Get rights and content

We report a case of uterine cancer and invasive cervical cancer, detected incidentally during the female-to-male sex reassignment surgery. The management of these patients is presented. Such individuals may not be receiving regular gynecologic care appropriate to their remaining genital organs; symptoms of malignant disease may be missed.

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Case Reports

Patient A is a 54 year old transsexual male who began sex reassignment with androgen administration in 2000. Prior to this, he noted menarche at 12 years of age, and he had amenorrhea since 2000. He had not had prior intercourse with women since the age of 18 years. He denied any history of abnormal Papanicolaou smears or sexually transmitted diseases. His most recent normal Papanicolaou smear was in 2007. He denied any history of human immunodeficiency virus, intravenous drug use, or blood

Comment

Approximately 1 in 30,000 women per year undergo sex reassignment treatment. During the hormonal treatment process, therapy with androgens induces a hypoestrogenic state leading to amenorrhea. Such changes lead to atrophy of the endometrium. Long-term androgen therapy has also been found to be associated with cervical atrophy. Although to the best of our knowledge, there has not previously been reported a case of uterine or invasive cervical carcinoma in a cohort of patients treated with

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