Testicular Feminization: Clinical, Morphological and Biochemical Studies

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Abstract
A patient with the syndrome of feminizing testes was studied before and after castration. Urinary and plasma steroid determinations indicated that the testes produced substantial amounts of both testosterone and estrogen. Estradiol-17β was approximately 10 times higher in testicular venous blood than in peripheral blood. Incubation of testis slices with progesterone-4-14C resulted in a 0.051% conversion to estradiol-17β; radioactive 17-hydroxy progesterone, 3 androstenedione and testosterone were also isolated by the carrier dilution technique. Incubation of testis slices with testosterone-4-14C resulted in a 0.23% conversion to estradiol-17β. Following intravenous administration of testosterone-4-14C most of the radioactivity was excreted in the urine as androsterone and etiocholanolone. There was no detectable peripheral conversion of labeled testosterone to estrogen. These findings are consistent with the hypothesis that this syndrome results from lack of a target organ response to androgen.