Gynaecomastia

Question 1

What is gynaecomastia?

Answer 1

benign proliferation of mammary gland tissue in males

Question 2

What are some causes of gynaecomastia?

Answer 2

Reduced testosterone to oestrogen ratio
(Physiological) Neonatal, pubertal
(Pathological) Oestrogen excess (e.g. Leydig cell tumor, Sertoli cell tumor, ectopic hCG-producing tumors (e.g., lung cancer, hepatocellular cancer), adrenocortical tumors, Liver cirrhosis, Hyperthyroidism)

Decreased testosterone Chronic kidney disease, Klinefelter syndrome, Mumps orchitis

Drugs (e.g. steroids, testosterone inhibitors)

Question 3

What are the clinical features of gynaecomastia?

Answer 3

Firm, concentric mass at the nipple areolar complex

May be tender

Question 4

How is gynaecomastia diagnosed?

Answer 4

(Labs) Serum levels of testosterone, estradiol, luteinizing hormone, and hCG
Liver function tests, renal function tests, thyroid hormone
Testicular examination
Mammography + US biopsy in suspected cancer cases

Question 5

What is the treatment for gynaecomastia?

Answer 5

Treat the underlying cause
(Testosterone replacement)
(Selective estrogen receptor modulators (e.g., tamoxifen))