Gynaecomazia in a HIV, Hepatitis B and C affected middle aged male: a case report

Abstract

Gynaecomazia is benign proliferation of male breast tissue. Asymptomatic gynaecomazia has a trimodal age distribution, occurring in neonatal, pubertal, and elderly males causing considerable anxiety to the patients. Although it is a common disease but its presentation in middle age is rare, which demands thorough investigations to look for underlying cause. The patient 42-year gentleman presented with bilateral enlarged breasts gradually progressive for two years. He did not experience any pain or discharge from nipples. He was an intravenous drug abuser, and has had pulmonary tuberculosis treated 14 years back. He also had infection by human immunodeficiency virus for nine years and was treated with anti-retroviral therapy. He was also tested positive for HBsAg and anti-HCV. To best of literature search, we could find only few case reports related to gynaecomazia in Nepal, neither from eastern region nor as a side effects of drugs. Also, gynaecomazia related to ART or anti-tubercular drugs were reported within few months or a year of commencement of therapy. Similarly, cases with multiple risk factor exposure have not been often reported.