A 19-year-old boy, referred for treatment of "bilateral undescended testicles," was found to have congenital anorchia. Conditions other than cryptorchidism may mimic this anomaly. These include severe virilization of a female child, idiopathic pseudohermaphorditism, true hermaphroditism, and the male counterpart of Turner's syndrome. A method of evaluating the "empty scrotum" is proposed to facilitate early diagnosis and treatment of anorchia. The goal is to prevent progressive eunuchoidism and the stigmata of sexual infantilism. Unlike most anorchid patients, the one reported here had normal body measurements and bone age. He also had relatively high levels of urinary total neutral 17-ketosteroids. Increased production of androgen precursors by the adrenal cortex may have prevented eunuchoidism without stimulating secondary sexual development.
Kolodny HD, Kim S, Sherman L, Futterweit W, Benjamin F. Anorchia: A Variety of the "Empty Scrotum". JAMA. 1971;216(3):479–482. doi:10.1001/jama.1971.03180290055007
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