A dynamic approach to gynaecomastia

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A dynamic approach to gynaecomastia

Journal Title: Indian Journal of Pathology and Oncology - Year 2018, Vol 5, Issue 1

Abstract

Introduction Gynaecomastia is characterized by enlargement of the male breast caused by glandular proliferation and fat deposition Although a fairly common presentation in the primary care setting and is mostly of benign etiology it can cause patient considerable anxiety Sometimes it could be due to serious underlying illness or a medication or inherited Breast cancer risk is slightly higher in males with gynaecomastiaAim To determine the prevalence pathophysiology etiology and therapy of gynaecomastia A stepwise approach that includes imaging and laboratory testing to exclude neoplasms and endocrinopathiesMaterials and Methods A one year prospective study of twenty four gynaecomastia cases was done A detailed clinical history taken and physical examination was done Laboratory investigations like hepatic renal and thyroid function tests hormonal levels like serum estradiol testosterone follicular stimulating luteinizing hormone levels prolactin human chorionic gonadotropin and dehydroepiandrosterone levels were done Other investigating aids like MRI and ultrasonography mammography cytogenetics were useful in some of them However histopathology proved to be gold standardResults We had twenty four cases of gynaecomastia of which there were one case of Klinefelter syndrome five cases each of idiopathic gynaecomastia two case each of true hermaphroditism one case each of androgen insensitivity syndrome Ehlers danlos syndrome cirrhosis drug induced renal failure hyperthyroidism testicular torsion androgen insensitivity syndrome choriocarcinoma pituitary adenoma adrenal neoplasm and Leydig cell tumour Six cases were those of physiological gynaecomastiaConclusions Gynaecomastia is a common condition that may be attributable to an oestrogen androgen imbalance caused by several etiological factors After confirming the diagnosis searching for a specific cause and classifying the case according to severity grade the therapy for gynaecomastia should be personalized Lifestyle guidance reassurance medical treatment and surgical correction are valid tailored therapeutic optionsKeywords Approach Breast Gynaecomastia Male

Authors and Affiliations

K. Anji Reddy, G. Vahini

Keywords

EP ID EP473189
DOI 10.18231/2394-6792.2018.0015
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