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Gynecomastia

Gynecomastia is the enlargement of breast tissue in males. It can affect one or both breasts.


Presentation

  • Atypical presentations of gynecomastia not associated with obesity are often underappreciated.[ncbi.nlm.nih.gov]
  • The most common presenting symptoms of the patients diagnosed with ITLCHSCN are gynecomastia, enlargement in the testicles, increase in growth velocity, and advanced bone age.[ncbi.nlm.nih.gov]
  • We present an immunocompetent pediatric patient who presented with gynecomastia and was found to have hyperprolactinemia. Imaging showed a sphenoid mass and referral was made for a pituitary tumor.[ncbi.nlm.nih.gov]
  • We discuss the presentation, management, and outcome of a giant, solid, invasive prolactinoma in a 7-year-old boy who presented with visual disturbances and gynecomastia.[ncbi.nlm.nih.gov]
  • One of the patients with glandular gynecomastia (12.5%) presented with recurrence at the time of follow-up, while five of the eight patients showing lipomatous gynecomastia (62.5%) presented with recurrence.[ncbi.nlm.nih.gov]
Neck Mass
  • We describe a unique case of gynecomastia presenting as a neck mass in a patient who was diagnosed and treated for squamous cell carcinoma of the floor of the mouth.[ncbi.nlm.nih.gov]
Breast Mass
  • This case report describes an otherwise healthy 3-year old non-obese boy who developed a large unilateral cystic breast mass measuring approximately 9 6 4 cm.[ncbi.nlm.nih.gov]
  • We report a rare case of a 45-year-old male presenting with a palpable breast mass that was suspicious of carcinoma clinically.[ncbi.nlm.nih.gov]
  • Mammography performed within 8 months of CT is unlikely to reveal cancer unless there is a suspicious clinical finding or a breast mass eccentric to the nipple.[ncbi.nlm.nih.gov]
  • Left breast mass in a 74 year old man Images hosted on other servers : Gynecomastia[pathologyoutlines.com]
  • View larger version (159K) Fig. 11A — 78-year-old man who presented with new right breast mass. Mediolateral oblique and craniocaudal views show superficial circumscribed right breast mass and small, but dense, bilateral axillary lymph nodes.[doi.org]
Large Breast
  • Gynecomastia is a condition that causes men to have large breast tissue. It can cause tenderness or pain in a man’s breasts. Hormone changes usually cause this condition, which can happen during infancy, adolescence, or old age.[healthcare.utah.edu]
  • Gynecomastia is a condition where men develop abnormally large breasts. The enlargement is not of fat but breast tissues.[news-medical.net]
  • Male breast reduction surgery Duke plastic surgeons correct abnormally large breasts in men by removing excess tissue, skin, and fat, while flattening and enhancing the male chest contours.[dukemedicine.org]
  • Convert to ICD-10-CM : 611.1 converts directly to: 2015/16 ICD-10-CM N62 Hypertrophy of breast Approximate Synonyms Atypical lobular hyperplasia of left breast Atypical lobular hyperplasia of right breast Breast hypertrophy Gynecomastia Large breast Macromastia[icd9data.com]
  • The medical term for this condition is gynecomastia, and is generally diagnosed when men grow abnormally large breasts due to the overdevelopment of breast tissue.[foxnews.com]

Workup

  • Because of its prevalence and presentation, the diagnosis of gynecomastia requires a comprehensive workup. A list of many common nondrug causes of gynecomastia can be found in Table 1.[uspharmacist.com]
  • This will include some lab testing such as routine blood work and a cardiac workup if you have any history of heart disease. Your surgeon will also discuss male breast reduction risks with you prior to surgery.[yourplasticsurgeryguide.com]
  • DIAGNOSTIC TESTING The history and physical examination should direct the laboratory and imaging workup ( Figure 1 ).[aafp.org]

Treatment

  • Five studies reported pharmacological intervention with tamoxifen and/or anastrozole, either as prophylactic or therapeutic treatment. Four studies reported radiotherapy as prophylactic and/or therapeutic treatment.[ncbi.nlm.nih.gov]
  • Therefore, pharmacological and surgical treatment should be avoided.[ncbi.nlm.nih.gov]
  • In conclusion, male patients who are to receive treatment with imatinib mesylate may be monitored for serum testosterone levels and for other reproductive hormone profiles before initiation of the treatment and their breasts may be examined during follow-up[ncbi.nlm.nih.gov]
  • Treatment with tamoxifen, a selective estrogen receptor blocker, has been shown to effectively reduce the disc size and is generally considered for treatment when the disc diameter is 3-4 cm.[ncbi.nlm.nih.gov]
  • The decrement of testosterone during isoretinoin treatment is defined in literature. We present a case with 20 years old man who developed gynecomastia after treatment with isotretinoin.[ncbi.nlm.nih.gov]

Prognosis

  • The cause and prognosis of PASH in NF-1 may be distinguished from that of conventional PASH, and mast cells, histiocytes and CD54 may play roles.[ncbi.nlm.nih.gov]
  • The occurrence of adverse effects of ART may interfere with therapy adherence and long-term prognosis and for that reason requires attention. We report the first case of prepubertal gynecomastia in a young girl attributed to efavirenz use.[ncbi.nlm.nih.gov]
  • Although PASH tends to grow over time, most lesions are cured by surgical excision and the prognosis is excellent. We report an unusual case of bilateral axillary tumoral PASH in a 44-year-old man.[ncbi.nlm.nih.gov]
  • […] and stromal changes are necessary for the diagnosis Radiology description There are two mammographic patterns associated with gynecomastia: Dendritic configuration (retroareolar with radial extensions) Triangular configuration (recent onset disease) Prognosis[pathologyoutlines.com]
  • Prognosis The progress of gynecomastia is determined by its cause. Resources Books Wilson, Jean D. "Endocrine Disorders of the Breast." In Harrison's Principles of Internal Medicine, edited by Anthony S. Fauci, et al.[medical-dictionary.thefreedictionary.com]

Etiology

  • The etiology of GM is attributable to physiological factors, endocrine tumors or dysfunctions, non-endocrine diseases, drug use or idiopathic causes.[ncbi.nlm.nih.gov]
  • Broadly, the main etiologies are medications, adrenal tumors, liver and kidney failure.[doi.org]
  • Etiology of breast enlargement in male HIV population and differential diagnosis between true gynecomastia and lipomastia are also discussed.[ncbi.nlm.nih.gov]
  • Although a fairly common presentation in the primary care setting and mostly of benign etiology, it can cause patients considerable anxiety. The initial step is to rule out pseudogynecomastia by careful history taking and physical examination.[ncbi.nlm.nih.gov]
  • The main aim of any intervention is to relieve the symptoms and exclude other etiological factors.[ncbi.nlm.nih.gov]

Epidemiology

  • Because of this unusual occurrence of gynecomastia, CDC was asked on November 30, to assist in an epidemiologic investigation.[cdc.gov]
  • A rare malignancy, male breast cancer, has in epidemiological studies been associated with prior history of gynecomastia [ 8 – 12 ].[bmccancer.biomedcentral.com]
  • […] palpable mass that can be tender in the initial stages Nipple and areola are enlarged in a minority of patients Essential features Epithelial hyperplasia and stromal edema or fibrous tissue with atrophic glands, depending on the type of gynecomastia Epidemiology[pathologyoutlines.com]
  • This drug can induce gynecomastia after one month only of treatment, with a dose-dependent incidence. 3 Among the H2 histamine receptor blockers, cimetidine seems to be the active principle that most frequently can cause gynecomastia: a retrospective epidemiological[pharmaco-vigilance.eu]
Sex distribution
Age distribution

Pathophysiology

  • Studies were selected for this review by performing an extensive electronic and hand-search using BIOSIS, EMBASE and Medline, from 1940 to present, for all reported drug associations of gynecomastia and their possible pathophysiology.[ncbi.nlm.nih.gov]
  • The pathophysiology of gynecomastia is also discussed in detail for each of the drugs found to have a good or fair evidence of association with gynecomastia.[doi.org]
  • Author information 1 Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza, University of Rome, Viale Regina Elena 324, 00161, Rome, Italy. andrea.sansone@uniroma1.it. 2 Department of Experimental[ncbi.nlm.nih.gov]
  • The aim of this review is to discuss the pathophysiology, etiology, evaluation and therapy of GM. A hormonal imbalance between estrogens and androgens is the key hallmark of GM generation.[ncbi.nlm.nih.gov]
  • Our report confirms the usefulness of scrotal ultrasonography for finding an occult testicular tumour in a patient with painful and recent onset bilateral gynecomastia and underlines: a) the important role of testosterone/estradiol ratio in the pathophysiology[ncbi.nlm.nih.gov]

Prevention

  • Breast pain 58% vs. 7% vs. 30% Toxicity: No difference in QoL between TAM and RT Conclusion: Gynecomastia and breast pain induced by bicalutamide after RP can be prevented.[en.wikibooks.org]
  • Steroid Gynecomastia Prevention For decades many athletes who use anabolic steroids have supplemented with the SERM Tamoxifen (Nolvadex) to combat such issues.[steroid.com]
  • Closed-suction drain placement is commonplace; however, the effect of drains on preventing complications after male breast surgery has not been fully elucidated in the literature.[ncbi.nlm.nih.gov]
  • Medical interventions to prevent or treat gynecomastia carry risk of additional detrimental side effects. However, untreated gynecomastia can be physically uncomfortable and psychologically distressing.[ncbi.nlm.nih.gov]
  • Can gynecomastia be prevented or avoided? Most cases of gynecomastia cannot be prevented. They are caused by natural changes in hormone levels. Adults can help prevent gynecomastia by avoiding certain medicines, drugs, and lifestyle factors.[familydoctor.org]

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Last updated: 2019-07-11 22:24