Hepatic glycogenosis (HG) is characterized by excessive glycogen accumulation in hepatocytes and represents a hepatic complication of diabetes that particularly occurs in patients with longstanding poorly controlled type 1 diabetes (T1D). HG has been reported to be a very rare disease, although it is believed to be extremely underdiagnosed because it is not possible to distinguish it from non-alcoholic fatty liver disease (NAFLD) unless a liver biopsy is performed. In contrast to HG, NAFLD is characterized by liver fat accumulation and is the more likely diagnosis for patients with type 2 diabetes and metabolic syndrome. The pathogenesis of HG involves the concomitant presence of insulin and excess glucose, which increases glycogen storage in the liver. HG is characterized by a transient elevation in liver transaminases and hepatomegaly. Differentiating between these two conditions is of the utmost importance because HG is a benign disease that is potentially reversible by improving glycemic control, whereas NAFLD can progress to cirrhosis. Therefore, HG should be suspected when liver dysfunction occurs in patients with poorly controlled T1D. The aim of this article is to review the epidemiology, clinical characteristics, pathogenesis and histology of HG.

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Objective: Gynecomastia is the benign enlargement of male breast tissue and is the most common breast condition in males. Beta human chorionic gonadotropin (b-hCG)secreting tumors such as choriocarcinoma are one cause of gynecomastia. This is the first report of bilateral gynecomastia secondary to malignant b-hCG-secreting choriocarcinoma located in the colon. Methods: A 49 year-old male who presented bilateral gynecomastia was found to have a primary colonic choriocarcinoma. Results: Serum b-hCG levels were significantly high at 11.546 mIU/mL (normal range 0.01-5). A colonoscopy showed a stenosing mass in the sigmoid colon, and computed tomography revealed multiple liver metastases. The diagnosis of choriocarcinoma was confirmed by the histologic and immunohistochemical biopsy findings. Conclusion: Primary colorectal choriocarcinoma is a very rare entity that should be considered in the differential diagnosis of gynecomastia. (AACE Clinical Case Rep. 2015;1:e260-e264) Abbreviation: b-hCG = b human chorionic gonadotropin.

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