# 46, XX disorder of sexual development associated with mixed germ cell tumor of the prostate: a rare case report

## TL;DR

A rare case of a 40-year-old male with a genetic disorder and a prostate tumor is reported, offering new insights into its genetic and clinical features.

## Contribution

This is the first reported case of a 46, XX disorder of sex development with a mixed prostate germ cell tumor.

## Key findings

- Whole-genome sequencing revealed a high somatic mutational load in the tumor cells.
- The patient's karyotype was confirmed as 46, XX (SRY +), with specific hormonal and physical characteristics.
- The case provides new insights into the clinicopathological and genetic profile of this rare condition.

## Abstract

Extragonadal germ cell tumors originating from the prostate are exceptionally rare. To the best of our knowledge, there have been no reported cases of mixed germ cell tumors in individuals with 46 XX disorder of sex development. In this study, we conducted a comprehensive analysis using whole genome sequencing to investigate the clinicopathological and molecular genetic characteristics of a submitted case, with the objective of elucidating its underlying pathogenesis.

A 40-year-old male patient was diagnosed with a combination of 46, XX disorder of sex development and a primary prostate mixed germ cell tumor with yolk sac tumor and teratoma components. Whole-genome sequencing revealed that the tumor cells had a high somatic mutational load. Analysis of genomic structural variations and copy number variants confirmed the patient's karyotype as 46, XX (SRY +). Additionally, the patient exhibited short stature, small bilateral testes, slightly enlarged breasts, elevated serum alpha-fetoprotein concentrations, elevated follicle-stimulating hormone and luteinizing hormone levels, and low testosterone levels.

A case of 46, XX disorder of sex development, along with a primary prostatic mixed germ cell tumor, was diagnosed. This diagnosis has contributed to advancing our understanding of the genetic and phenotypic profile of the disease and may provide some insights for its treatment.