Adolescent Gynecomastia: Differential Diagnosis and Management

Mahoney, C. Patrick

doi:10.1016/s0031-3955(16)37016-x

Cited by 47 publications

(2 citation statements)

References 54 publications

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“…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%

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%

Imaging in gynecomastia

2021

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“…Гинекомастия — это, как правило, доброкачественная пролиферация ткани молочных желез у представителей мужского пола, возникающая вследствие дисбаланса между действием эстрогенов, стимулирующих рост ткани молочных желез, и блокирующим действием андрогенов. В детском возрасте в подавляющем большинстве случаев гинекомастия имеет физиологический характер и возникает в грудном возрасте и у подростков в период пубертата [ 1 ]. Пубертатная гинекомастия возникает, по разным данным, у 20–70% мальчиков-подростков и проходит самостоятельно примерно через 6 мес, в некоторых случаях может персистировать до 1–2 лет, редко она может сохраняться и требовать хирургической коррекции в косметических целях [ 2 ].…”

Section: актуальностьunclassified

Prepubertal gynecomastia at the debut of hereditary tumors predisposition syndrome (clinical case reports)

Kareva,

Sozaeva,

Chugunov

et al. 2023

Probl Endokrinol (Mosk)

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Peutz-Jeghers Syndrome (Peutz-Jeghers Syndrome, PJS) refers to syndromes of hereditary tumor predisposition and is caused by pathological variants of the STK11 gene, leading to a defect in the synthesis of serine/threonine kinase 11 protein, which acts as a tumor suppressor.Clinical symptoms of the syndrome are combination of hamartomatous polyposis of the gastrointestinal tract and specific skin-mucosal hyperpigmentation. Also, this disease is characterized by a high risk of developing gastrointestinal and extra-intestinal tumors, including benign or malignant tumors of the reproductive system.One of the first signs of the disease in male patients may be prepubertal gynecomastia associated with large-cell calcifying Sertoli cells tumors expressing aromatase. In contrast to from pubertal gynecomastia, prepubertal is extremely rare, and it is often based on pathological causes. Early diagnosis of patients with pre-pubertal gynecomastia, including Peitz-Jaegers syndrome, defines the tactics of gynecomastia management and protocols for monitoring the development of other components of the disease in the future.This article describes two patients with pre-pubertal gynecomastia and Peitz-Jaegers syndrome with different molecular genetic defects: in one case associated with duplication of the STK11 gene site, in the other — with microdeletion of the short arm of chromosome 19 containing this gene.

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