MSFinals-1137

MSFinals-1137

A 23-year-old man presents to the Emergency Department after being involved in a fight. He had been in the shower after a gym session, when someone made a derogatory comment about his body, and that started the fight. A history reveals that he has had three girlfriends in the last 3 months, but none of the relationships have lasted. He admits that he struggles to achieve an erection. On examination, the patient is of normal height with normal pubic hair. His penis is small and his breasts are enlarged. He said that he had started growing breasts from the age of 11. This often caused him embarrassment. His blood pressure is 119/73 mmHg.
Which of the following syndromes must be ruled out?