Perspectives in Pediatric Pathology, Chapter 6. Male Undermasculinization

Pediatr Dev Pathol. 2015 Jul-Aug;18(4):279-96. doi: 10.2350/14-04-1465-PB.1. Epub 2014 Aug 8.

Abstract

Normal male development requires three conditions: (1) adequate differentiation of the fetal testis; (2) synthesis and secretion of testicular hormones; and (3) effective action of these hormones on target organs. This requires the combined action of the inhibitory anti-müllerian hormone (AMH, secreted by Sertoli cells) to block the development of the uterus and fallopian tubes from the müllerian duct, together with the trophic stimulus of testosterone (a Leydig cell product), which leads to virilization of the wolffian ducts. Additionally, the development of external genitalia depends on the conversion of testosterone to dihydrotestosterone by the enzyme 5-α-reductase. Failure of any of these mechanisms leads to deficient virilization or the so-called "male pseudohermaphroditism" syndromes.

Publication types

  • Review

MeSH terms

  • 3-Oxo-5-alpha-Steroid 4-Dehydrogenase / metabolism
  • Anti-Mullerian Hormone / metabolism
  • Biopsy
  • Cell Differentiation
  • Disorders of Sex Development / genetics
  • Disorders of Sex Development / metabolism
  • Disorders of Sex Development / pathology*
  • Female
  • Genetic Predisposition to Disease
  • Humans
  • Male
  • Masculinity*
  • Phenotype
  • Predictive Value of Tests
  • Sex Determination Processes*
  • Signal Transduction
  • Testis / metabolism
  • Testis / pathology*
  • Testosterone / metabolism
  • Virilism

Substances

  • Testosterone
  • Anti-Mullerian Hormone
  • 3-Oxo-5-alpha-Steroid 4-Dehydrogenase