ABSTRACT
Background: Clitoromegaly is often a sign of androgen excess; however, non-hormonal causes must be ruled out. We report the case of an adolescent with isolated clitoromegaly without clinical or biochemical evidence of hyperandrogenism. Case: A 16-year-old female was referred due to a clitoromegaly of 12 months of evolution. Examination of the pubic region revealed normal female genitalia with an enlarged clitoris, 4 cm long and 2.5 cm wide. The clitoris was painless, soft on palpation, and mobile over deeper layers. There were no signs of virilization, and the patient did not report dysuria or difficulties with sexual intercourse. Her medical record was also unremarkable, with no female circumcision, family history of birth defects, or genital abnormalities. Hormone profile blood tests were normal. Pelvic ultrasound examination was normal, but a high-resolution scan with a linear transducer confirmed the presence of a cyst, lying anterior to the clitoral body and glans. The cyst was surgically removed with special care to preserve the clitoral neurovasculature. The pathological report disclosed an epidermoid clitoral cyst. The patient described emotional well-being, satisfactory sexual function, and no discomfort after a year of follow-up. Conclusion: Epidermal clitoral cysts represent an unusual cause of clitoromegaly. These cysts should be ruled out as a differential diagnosis after an exhaustive semiological and endocrinological examination.
ABSTRACT
La placenta es un órgano imprescindible para llevar adelante la gestación en mamíferos domésticos. Está constituida por tejidos maternos y fetales y cumple numerosas funciones: intercambio de gases, nutrientes y excreción de productos de desecho, función inmune a nivel de tolerancia y transferencia, función endócrina sintetizando hormonas y factores de crecimiento. Existe una gran diversidad estructural en las placentas de diferentes especies animales. Las clasificaciones de mayor relevancia son la que dependen de la descripción morfológica macroscópica, basada en la distribución de las vellosidades placentarias en el corion del feto y la clasificación histológica, fundamentada en el número de capas que se interponen entre la sangre materna y la fetal, determinando la transferencia de inmunoglobulinas (Igs) a través de este órgano. El objetivo del presente trabajo es describir la estructura placentaria en diferentes especies y su impacto en la transferencia de la inmunidad materno-fetal. (AU)
The placenta is an essential organ for pregnancy in domestic mammals. It is constituted by maternal fetal tissues and fulfills numerous functions: exchange of gases, nutrients and excretion of waste products, prevents the immune system from identifying the embryo as a foreign body and synthesizes hormones and growth factors. There is great structural diversity in placentas of different animal species, and those can be classified in different ways. The most relevant is the macroscopic morphological classification, which is based on the distribution of the placental villi in the corium of the fetus, and the histological, that relies on the number of layers between maternal and fetal blood, determining if there is immunoglobulin (Ig) transfer or it is carried out through the colostrum. The objective of the work is to describe the placental structure in different species and its impact on the transfer of maternal-fetal immunity. (AU)
