Gynecomastia is a benign enlargement of the male breast, secondary to gland proliferation and is a common problem among the male population. Treatment is primarily surgical. The most common intra-and postoperative complication is bleeding, followed by seroma, infection, insufficient results, inverted nipple and nipple necrosis. The embolism is one of the non-specific complications. A 24-year-old male was presented to the Surgery Department with a diagnosis unilateral gynecomastia. The operation proceeded without complication and around 10 hours later, the patient complained of weakness in all four limbs, later nausea, and vomiting and after full cardiopulmonary resuscitation, the patient died. The main reason for the patient's death was concluded to be a postoperative pulmonary thromboembolism and fat embolism was discovered. In addition, there was a papillary carcinoma of the thyroid, which was missed before. We reported that unilateral gynecomastia associated with papillary carcinoma of the thyroid detected rarely at autopsy and fat embolism after surgery for gynecomastia is a rare complication.

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and correlation models determined associations between OHAs and survivals.Results: 108 patients (52%) were diabetic. Of these, 69 received metformin, 43 sulfonylureas, 7 thiazolideniodiones, 21 DPP inhibitors, and 32 insulin. Age of diabetics were 58.6 yr v 53.2 yr,p¼0.0018. Metformin prescribed more to luminal patients v non-luminal (57 v 26%, p¼0.002); luminal diabetics on metformin were 71% v 55 % non-luminal,p¼ 0.18 After a median follow-up of 10 years, the full diabetic cohort had a non-significant trend to shorter median overall survival (OS) relative to nondiabetics (91.5 v 99.8 months, p¼0.13). The median OS of all patients taking OHAs was similar to those not (95 v 96 months, p¼0.7). Those on metformin had a numerically longer median OS (95 v 88 months, p¼0.20) whereas those on sulfonylureas and those on insulin had numerically shorter median OS (92 v 97 months, p¼0.2 and 92 v 97 months, p¼0.3 respectively). BrCa specific median survival was 36 v 47 months for non-cancer related deaths, p ¼0.3. No impact of OHAs was noted when examining different sub-types. Regression analysis revealed no significant association of metformin (p¼0.50), T2DM with metformin (p¼0.14), cause of mortality (0.22) with survival time and mortality. Further, correlation analysis suggest strong negative correlation was observed among them (r ¼ -0.84, p<0.0001).Conclusions: Metformin had no significant impact on survival outcomes in diabetic Indigenous patients with BrCa. Analysis of metabolic syndrome and diabetes in the context of a larger cohort is needed to exclude impact of anti-diabetic pharmacotherapy on prognosis.