“…While a clear genotypephenotype correlation could not be established to date, the acampomelic form appears to be mild by comparison. Of 11 ACD cases in the literature in whom SOX9 mutations were reported, five carry missense mutations (Friedrich, et al, 2000;Michel-Calemard, et al, 2004;Moog, et al, 2001;Sock, et al, 2003; while the other six carry deletions or rearrangements directly affecting a cis-acting element upstream of the SOX9 coding region but not the coding region itself (Hill-Harfe, et al, 2005;Lecointre, et al, 2009;Leipoldt, et al, 2007;Ninomiya, et al, 1996;Velagaleti, et al, 2005). Of 8 cases with ACD and a XY karyotype, 4 cases (1 balanced translocation with a breakpoint upstream from the coding region, 3 missense mutations) do not show sex reversal.…”