Which patients with gynaecomastia require more detailed investigation?

Ali, Sara N.; Jayasena, Channa N.; Sam, Amir H.

doi:10.1111/cen.13526

Cited by 6 publications

(10 citation statements)

References 34 publications

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“…Once the diagnosis has been established, the identification of the cause follows. A detailed history and a careful physical examination are enough to reveal the cause of GM in most cases, while laboratory investigation is mainly required for proving a clinical suspicion or unclear cases 1,20,48 …”

Section: Discussionmentioning

confidence: 99%

“…Laboratory examination is usually not needed in pubertal GM, as most cases concern transient GM. Exception are cases of rapid progression and enlargement > 4 cm in diameter, which may be associated with a serious underlying condition, or persistence for more than one year or after the age of 17 years 48,64 . 65 Laboratory examination is usually not needed for the long‐standing asymptomatic GM, which is incidentally noted on physical examination of old men with a normal history.…”

Section: Discussionmentioning

confidence: 99%

“…47 In a similar mechanism, ectopic hCG production by non-trophoblastic tumors, such as large-cell carcinoma of the lung, gastric carcinoma, or renal cell carcinoma, may cause GM in rare cases. 32,48 Adrenocortical neoplasms, especially carcinomas, have also been reported to cause rapidly progressive GM via direct secretion of estrogens or conversion of overproducing androgen precursors into estrogens in peripheral tissues. 5,49,50,51 A common cause of GM, characterized by high T and E 2 but low LH concentrations, are anabolic-androgenic steroids (AAS); the mechanism is the peripheral aromatization of excessive androgens to estrogens.…”

Section: Causesmentioning

confidence: 99%

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Imaging in gynecomastia

2021

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Background: Gynecomastia (GM) is the benign proliferation of glandular tissue in the male breast. It is a common condition, which may occur physiologically and shows three age peaks during a male's lifespan: infancy, puberty, and senescence. An underlying pathology may be revealed in 45%-50% of adult men with GM, such as aggravating medications, systemic diseases, obesity, endocrinopathies, or malignancy.Objective: To discuss the role of imaging in the evaluation of GM and its contribution to therapeutic decision-making. Materials/methods:The current literature was reviewed through PubMed, Scopus, and CENTRAL electronic databases to identify the best available evidence concerning imaging modalities in patients with GM.Results: Most male breast lesions can be diagnosed on clinical grounds; however, in certain cases, when physical examination is inconclusive, imaging may be helpful. Discussion:The main purpose of evaluating a patient with GM is to establish the diagnosis and differentiate true GM from pseudogynecomastia, exclude breast cancer, and detect the possible cause. GM is seen in mammography as a subareolar opacity and three mammographic patterns of GM are described: nodular, dendritic, and diffuse, corresponding to florid GM of early onset, fibrous persistent GM, and GM due to exogenous estrogen administration, respectively. In ultrasound (US), florid GM is depicted as a disk-shaped, hypoechoic area underlying the areola, whereas echogenicity of the lesions increases as fibrosis develops. Data on the use of MRI in the evaluation of the male breast and GM are still limited. Imaging findings can be classified according to the BIRADS (breast imaging reporting and data system) based on their malignant potential. Conclusion:Both mammography and US are sensitive and specific to diagnose GM and distinguish it from breast cancer. When clinical findings are suggestive of malignancy or imaging findings are inconclusive, a histological confirmation should be sought.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Causesmentioning

confidence: 99%

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Imaging in gynecomastia

2021

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“…4,5 Secondary causes of gynecomastia include medications, chronic liver or kidney disease, hypogonadism, hyperthyroidism, and malignancy, including human chorionic gonadotrophin (hCG) tumours, Leydig, Sertoli, granulosa cell testicular tumours as well as estrogen secreting adrenal tumours. 6 Management of pubertal gynecomastia is tailored to the individual patient. Due to the high rate of spontaneous remission, conservative follow up is recommended for those who are not distressed by their condition.…”

Section: Discussionmentioning

confidence: 99%

“…The secondary causes of gynecomastia include medications; chronic liver or kidney disease; hypogonadism; hyperthyroidism; and malignancy (including human chorionic gonadotropin tumors; Leydig, Sertoli, and granulosa cell testicular tumors; as well as estrogen-secreting adrenal tumors). 8 …”

Section: Discussionmentioning

confidence: 99%

Gynecomastia in a Transgender Boy: A Case Report

Fung

Greenaway

McEvenue³

2021

AACE Clinical Case Reports

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This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Diagnosis and Management of Gynecomastia for Urologists

Baumgarten

Dabaja

2018

Curr Urol Rep

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Recent studies investigating tamoxifen and radiation therapy for both therapy and prophylaxis of bicalutamide-induced gynecomastia are reviewed. Gynecomastia is a common clinical problem, affecting between one and two thirds of middle-aged men. Diagnosis is typically made by history and physical exam. Common causes include chronic medical conditions and medications; however, unexplained gynecomastia should prompt laboratory work-up, followed by appropriate imaging studies to evaluate for hormone producing cancers. For patients taking bicalutamide for treatment of prostate cancer, tamoxifen or radiation therapy for gynecomastia are excellent options.

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Which patients with gynaecomastia require more detailed investigation?

Cited by 6 publications

References 34 publications

Imaging in gynecomastia

Imaging in gynecomastia

Gynecomastia in a Transgender Boy: A Case Report

Diagnosis and Management of Gynecomastia for Urologists

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