Incidental Gynecomastia on Thoracic Computed Tomography in Clinical Practice: Characteristics, Radiologic Features, and Correlation With Possible Causes in South Korean Men

Abstract

Gynecomastia is a common incidental finding on thoracic computed tomography (CT). This study aimed to retrospectively determine the prevalence, imaging characteristics, and possible causes of incidental gynecomastia on thoracic CT. Records of male patients who underwent thoracic CT in 2015 were reviewed. The size and morphologic types (nodular, dendritic, and diffuse) were recorded for patients with breast glandular tissue larger than 1 cm, and the cutoff value of gynecomastia was defined as 2 cm. Additionally, the possible causes of gynecomastia obtained by reviewing patients’ charts were recorded. CT-depicted gynecomastia was identified in 12.7% (650 of 5,501) of patients. The median size of the breast glandular tissue was 2.5 cm (interquartile range 2.2–3.1), and 36.8% of patients (239 of 650) had unilateral gynecomastia. The age distribution provided a bimodal pattern with two peaks in the age groups from 20 to 29 years old and greater than 70 years old. Chronic liver disease (CLD; p < .001), all stages of chronic kidney disease (CKD; p < .001), and medications ( p = .002) were significantly associated with gynecomastia. Gynecomastia did not correlate with body mass index ( p = .962). The size of breast glandular tissue was identified to be correlated with the morphologic type of breast tissue and the severity of CLD or CKD. The prevalence of incidental gynecomastia seen on thoracic CT was 12.7%. CT-depicted gynecomastia is not associated with obesity but with CLD, CKD, and medications. When gynecomastia is detected on CT, further evaluations and management might be required for patients with a treatable cause.

An Approach to Gynecomastia in Primary Care Clinics

“…In comparison with controls, the main predisposing factors were liver and kidney disease 6 . One study showed a positive correlation between prevalence and diameter of breast tissue in patients with higher body mass indices, 4 but when analyzing incidental gynecomastia on CT films, the correlation was not observed 6 . Although the prevalence of true gynecomastia has been described in various populations in several studies, the prevalence of pseudogynecomastia, identified by physical examination or ultrasound findings, has not been reported in the literature.…”

“…In hospitalized patients, the highest prevalence occurred in men 50 to 69 years old 4 ; however, in computed tomography (CT) studies of patients with preexisting disease and health checkups, the prevalence was highest between 10 to 19 years and older than 70 years of age. In comparison with controls, the main predisposing factors were liver and kidney disease 6 . One study showed a positive correlation between prevalence and diameter of breast tissue in patients with higher body mass indices, 4 but when analyzing incidental gynecomastia on CT films, the correlation was not observed 6 .…”

“…In comparison with controls, the main predisposing factors were liver and kidney disease. 6 One study showed a positive correlation between prevalence and diameter of breast tissue in patients with higher body mass indices, 4 but when analyzing incidental gynecomastia on CT films, the correlation was not observed. 6 Although the prevalence of true gynecomastia has…”

May hepatic steatosis be associated with gynecomastia and epicardial fat? A retrospective study of 599 male patients

“…Glandular tissue of ≥2 cm in the subareolar area is generally accepted as gynecomastia (8). The prevalence of gynecomastia has been reported between 32-65% depending on the diagnostic method, age and lifestyle (9). However, the actual incidence of gynecomastia in the general population is not clear, because most of these patients are asymptomatic and breast screening is not routinely performed in men.…”

“…et alreported the mean age as 56.99 years in 650 male patients with gynecomastia(9). Aslan et al reported the most common age group with gynecomastia as 30-39 years (8).…”