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Case Reports
. 2019 May 9;11(5):e4630.
doi: 10.7759/cureus.4630.

Prostate Cancer, Gender Identity, and Testosterone Replacement Therapy in Klinefelter Syndrome: A Case Report and Literature Review

Erin Nishikawa  1 , Sangyang Jia  1 , Celina Dharamshi  1 , Victoria Charron  2 , Michael Lock  3
Affiliations
Case Reports

Prostate Cancer, Gender Identity, and Testosterone Replacement Therapy in Klinefelter Syndrome: A Case Report and Literature Review

Erin Nishikawa et al. Cureus. .

Abstract

Klinefelter syndrome (KS), karyotype 47, XXY, is a common cause of hypogonadism in males. Patients with this condition often experience symptoms of gonadal failure, which can precipitate gender identity challenges. Treatment with testosterone replacement therapy (TRT) can combat these symptoms by improving sexual function, muscle mass, bone health, and virilization, thereby enhancing the quality of life (QOL). Although TRT is often employed in patients with KS, there is a concern that the application of exogenous testosterone may increase the risk of prostate adenocarcinoma development and progression. We report the case of a 58-year-old male with KS who is also diagnosed with prostate adenocarcinoma and wished to remain on TRT post-radiation therapy in support of his gender identity and QOL. We describe the challenges this patient faced when balancing a rising prostate-specific antigen level and risk of cancer recurrence with his QOL.

Keywords: gender identity; hypogonadism; klinefelter syndrome; prostate cancer; testosterone replacement therapy.

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Conflict of interest statement

The authors have declared financial relationships, which are detailed in the next section.

Figures

Figure 1
Figure 1. Timeline of events regarding PSA, TRT, and prostate cancer treatments
PSA1, prostate-specific antigen in u/L; TRT2, testosterone replacement therapy; T3, testosterone in nmol/L
See this image and copyright information in PMC

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