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A 43-year-old man, who is an identical twin, presented with a 2-year history of lethargy, weakness, and headaches and a several-year history of gradual loss of body hair and declining libido. He had undergone left orchidopexy at 6 years of age. A physical examination revealed features of hypopituitarism and hypogonadism, including central adiposity, nipple pallor, proximal muscle wasting, preservation of scalp hair, loss of body hair, gynecomastia, and right and left testicular volumes of 12 ml and 5 ml, respectively (normal volume, >15). A remarkable feature was the contrast in appearance between the hypogonadal patient (Panel A, right side) and . . . [Full Text of this Article] |