CT measurement of breast glandular tissue and its association with testicular cancer

Abstract

• CT breast glandular tissue diameter correlates with log(b-HCG) • Gynaecomastia in CT is associated with worse prognosis • Gynaecomastia in CT is associated with non-seminoma histological subtype.

Incidental Gynecomastia on Thoracic Computed Tomography in Clinical Practice: Characteristics, Radiologic Features, and Correlation With Possible Causes in South Korean Men

“…CT is not usually used as a diagnostic for gynecomastia. However, with the increased use of CT imaging for a variety of other conditions, incidental gynecomastia is frequently detected (Gossner, 2019;Klang et al, 2017Klang et al, , 2018Sonnenblick et al, 2016;Yi et al, 2008). The prevalence of gynecomastia varies widely depending on the population studied, specific imaging modality, and diagnostic criteria applied, ranging from 32% to 65% (Andersen & Gram, 1982;Carlson, 1980;Georgiadis et al, 1994;Niewoehner & Nuttal, 1984;Nuttall, 1979;Williams, 1963), and earlier studies yielded a much higher prevalence than this study.…”

“…Multivariable analysis revealed that CLD, CKD, and medications were significantly associated with gynecomastia. In another previous CT-based study (Klang et al, 2017), LC and end-stage renal disease were significantly associated with gynecomastia. Although not precisely the same, both CKD and CLD are associated with both gonadal and a hypothalamic-pituitary dysfunction leading to a decrease in the total plasma testosterone levels (Carrero et al, 2011;Cuhaci et al, 2014;Edey, 2017;Foresta et al, 2008;Iglesias et al, 2012;Schmidt et al, 2002).…”

“…However, studies aimed at determining whether obesity-induced hypogonadism is severe enough to cause gynecomastia are lacking. A recent CT-based study (Klang et al, 2017) has reported that obesity (BMI and subcutaneous fat measurements) does not significantly contribute to gynecomastia. Similarly, the current study demonstrates that there was no statistical correlation between BMI and gynecomastia, and BMI and the size of breast tissue.…”

“…Medical records were reviewed to obtain patient demographics, indications for imaging, and medical history predisposing to gynecomastia, such as chronic liver disease (CLD), fatty liver, chronic kidney disease (CKD), medication, alcoholism, adrenal tumor, liver metastasis, HIV, thyrotoxicosis, germ cell tumor, and Klinefelter syndrome (Braunstein, 2007;Cuhaci et al, 2014;Deepinder & Braunstein, 2012;Gossner, 2019;Klang et al, 2017Klang et al, , 2018Nuttall, 2010;Nuttall et al, 2015;Sonnenblick et al, 2016). From January 2015 through December 2018, any patients with symptoms associated with gynecomastia or who had undergone further imaging (such as MG or US) were also identified.…”

“…Unlike mammography (MG) or ultrasonography (US), computed tomography (CT) is generally not intended for palpable breast masses in men. With the widespread use of thoracic CT for a variety of other indications, gynecomastia has been commonly reported as an incidental finding on thoracic CT (Gossner, 2019;Klang et al, 2017Klang et al, , 2018Sonnenblick et al, 2016;Yi et al, 2008). The actual prevalence of gynecomastia initially detected on thoracic CT has, to date, not been well established owing to small patient numbers.…”