Turner Syndrome with Y Chromosome: Spontaneous Thelarche, Menarche, and Risk of Malignancy

Elizabeth Dabrowski*, Emilie K. Johnson, Vrunda Patel, Yeo Ching Hsu, Shanlee Davis, Allison L. Goetsch, Reema Habiby, Wendy J. Brickman, Courtney Finlayson

*Corresponding author for this work

Research output: Contribution to journalArticle

Abstract

Study Objective: Girls with Turner syndrome with Y-chromosome material (TS + Y) are assumed to have nonfunctional gonads with increased tumor risk, therefore prophylactic gonadectomy is recommended at diagnosis. In this study we aimed to determine rates of spontaneous thelarche (ST) and spontaneous menarche (SM), and prevalence of gonadal tumor and malignancy in girls with TS + Y, to further inform discussions about gonadectomy. Design: Retrospective review of clinical and pathology data. Setting: Multicenter study involving 4 United States children's hospitals. Participants: Patients included those with a genetically proven diagnosis of TS + Y and phenotypically female genitourinary exam. Interventions: Demographic characteristics, pubertal development, and gonadal pathology data were abstracted from clinical records. Data for ST were analyzed for patients aged 13 years and older and SM for patients older than 15 years. Main Outcome Measures: ST, SM, prevalence of gonadal tumor, and malignancy. Results: Forty-four patients met inclusion criteria. Nineteen patients were 13 years or older; 8/19 (42%) had ST and reached Tanner stages 2-4 and 2 (11%) had normal ovarian pathology. Nineteen patients were 15 years or older; 2/19 (11%) had SM. Thirty-seven patients underwent gonadectomy; 35 had available pathology results. Gonadoblastoma was identified in 35/7 patients (19%), 1 in situ germ cell neoplasia, and 1 dysgerminoma (3%). One patient with bilateral gonadoblastoma had ST and SM. Conclusion: In this multicenter cohort, 42% of girls with TS + Y entered puberty spontaneously and 11% had SM, supportive of gonadal function. Risk of tumor was similar to previous reports. To achieve informed decision-making, discussions about gonadectomy should incorporate potential for gonadal function and tumor risk.

Original languageEnglish (US)
Pages (from-to)10-14
Number of pages5
JournalJournal of pediatric and adolescent gynecology
Volume33
Issue number1
DOIs
Publication statusPublished - Feb 2020

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Keywords

  • Gonadal dysgenesis
  • Gonadoblastoma
  • Infertility
  • Ovarian insufficiency
  • Sex chromosome DSD
  • Turner syndrome
  • Turner syndrome with Y chromosome

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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