Sonography of pediatric male breast masses: gynecomastia and beyond

Abstract

Palpable breast masses are rare in the male pediatric patient and sonography is the primary imaging modality. The overwhelming majority of these cases are adolescent boys presenting with gynecomastia. Other diagnoses such as galactocele(s), hemangiomas, and ductal ectasia should be considered when young male patients present with a palpable mass. Malignant breast lesions are rare and are likely to be metastatic or primary tumors of non-breast tissue origin.

Breast diseases in children: the spectrum of radiologic findings in a cohort study

“…Gynecomastia may occur in neonatal or pubertal period while it is most commonly encountered in adolescence (2,5,6,17). However, in our study, gynecomastia, generally bilateral, was detected mostly in the 8-15 years age group, one or two years after the onset of puberty.…”

“…However, premature thelarche is also defined as the onset of breast development before the age of 8 years (25). Finally, an overlapping meaning can be noted for pseudogynecomastia, also called lipomastia or augmented adipose tissue (1,7,17,18), as well as for pediatric macromastia, which is also known as juvenile hypertrophy (23).…”

Breast Masses In Children

“…This entity is uncommon in prepubertal boys, and often it is associated with endocrine syndromes or tumors (16). At puberty, two-thirds to three-fourths of boys have some degree of breast enlargement, which peaks at 13-14 years and usually resolves within two years (10,17). The age of eight patients (21%) diagnosed with gynecomastia in our series varied between 9 to 15 years (mean = 13 years).…”

Breast Disorders

“…Galactoceles may be unilateral, bilateral or multiple and present as painless enlarging masses. Cyst aspiration yields milky fluid with variable fat and water content (Welch et al 2004). The imaging appearances reflect the cyst content; on US, water is anechoic and fat hyperechoic.…”