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At least 19 recordsLinked to original sources
PubMed1997

"Diabetic mastopathy" in the male breast--a special type of gynecomastia. A comparative study of lymphocytic mastitis and gynecomastia.

Focal B-lymphocytic mastitis and focal fibrosis of the breast in young women have rarely been reported as a complication of longstanding insulin-dependent diabetes mellitus type I. We present two cases of "diabetic mastopathy" in male diabetics suffering from gynecomastia. Furthermore, these two cases were examined in comparison to a selected group of 6 patients showing gynecomastia with a marked inflammatory reaction, as well as to 24 non-selected cases of common gynecomastia. The lesion is interpreted as a diabetes-induced autoimmune reaction of the breast and may be regarded as a lympho-epithelial lesion. Its histopathological characteristics are a marked chronic periductal and perivascular mastitis with a predominance of B-lymphocytes, a focal homogenous fibrosis and so called "epithelioid stromal fibroblasts" within the fibrotic matrix. Our findings support the existance of "diabetic mastopathy" in the male and point out to the potentially misleading pattern of this benign tumor-like lesion simulating gynecomastia.

Adolescent↗
PubMed1990

Hormonal studies and physical maturation in adolescent gynecomastia.

As part of a 3-year longitudinal study of lipid and hormonal changes during puberty, 536 boys aged 10 to 15 years were prospectively followed every 6 months to assess development of gynecomastia. The overall prevalence of gynecomastia in the 377 with complete data was 48.5% (51% of white subjects and 46% of black subjects). In the majority of subjects, gynecomastia developed during mid-puberty. Gynecomastia was bilateral in 55% of subjects, on the left side in 19%, and on the right in 26%. Gynecomastia was documented for only one visit in the majority of subjects. When subjects were matched at the onset of gynecomastia for race, visit number, and pubertal rating, there were no significant differences between those with or without gynecomastia in serum estradiol level, testosterone level, estrogen/testosterone, ratio, or dehydroepiandrosterone-sulfate level. However, free testosterone level, weight, and Quetelet index were all significantly lower, and the testosterone-estrogen binding globulin level was significantly greater, in those with gynecomastia. We conclude that approximately half of adolescent boys have transient gynecomastia, usually lasting less than 1 year; those with gynecomastia enter mid-puberty at an earlier age, have a lower Quetelet index, and have lower serum free testosterone levels.

Adolescent↗
PubMedDate not supplied

Gynecomastia due to hormone therapy for advanced prostate cancer: a report of ten surgically treated cases and a review of treatment options.

AIMS AND BACKGROUND: Gynecomastia is an abnormal increase in the volume of the male breast that is generally considered to be due to an increased estrogen/androgen ratio. Pathological causes of gynecomastia include organic diseases and therapy, such as the administration of estrogens and antiandrogens, which alter the ratio of circulating hormones. Hormone therapy for prostate cancer is generally well tolerated but often accompanied by the occurrence of gynecomastia and breast pain or tenderness. The increased use of antiandrogens as monotherapy is leading to an increase in the number of patients affected by gynecomastia. Treatments are available to alleviate or prevent the development of gynecomastia, including medical treatment with antiestrogens and aromatase inhibitors. Alternatively, mastectomy with excision of the gland, liposuction or an association of the two techniques have proved to be effective. Radiation therapy may provide effective relief from the breast pain associated with gynecomastia. In this paper we show the good results of mastectomy performed with a lower semicircular periareolar incision in men suffering from gynecomastia due to antiandrogen therapy for inoperable prostate cancer. In addition, we present a review of the various techniques used for the treatment of gynecomastia. METHODS AND STUDY DESIGN: During the period from September 1998 to May 2001, 10 patients receiving hormone treatment for metastatic or inoperable prostatic cancer were selected for the study if they had breast pain and bilateral gynecomastia. Five of these patients had been offered prophylactic radiotherapy before treatment but refused, while the remaining five patients had refused radiotherapy after hormone treatment. These patients were therefore given the option of surgical treatment. Before surgery all patients underwent clinical and ultrasound examination of the breast. All surgical samples were examined histopathologically. During follow-up clinical examinations were carried out one week, one month, six months, one year and two years after surgery. RESULTS: The results were satisfactory in all patients especially from an aesthetic point of view. Moreover, breast pain disappeared about one week after surgery. After a follow-up of 6-36 months (average, 22.8 months) no recurrences were observed. Only a few immediate postoperative complications were recorded (hematoma in one case and seroma in another). Histological examination of the excised glands showed fibrosclerotic tissue and a small amount of fat. CONCLUSION: Surgical liposuction can be considered an effective treatment for gynecomastia, in particular in the very early stages because the breast becomes irreversibly fibrous as the disease progresses. This surgical technique is simple and effective and is therefore to be considered favorable, especially because of the very short hospitalization and the absence of complications.

Androgen Antagonists↗
PubMed2000

Neither gynecomastia nor galactorrhea is a common side effect of neuroleptics in male patients.

OBJECTIVE: Gynecomastia is known to be a side effect of neuroleptics. The authors investigated the prevalence of gynecomastia and galactorrhea in a group of regularly neuroleptic-treated male patients. METHODS: Gynecomastia was defined as a palpable, discrete button of firm subareolar tissue measuring at least 2 cm in diameter. The subjects were 100 male patients who were taking neuroleptic treatment regularly. Each patient gave informed consent for the research involved in this study. RESULTS: (1) Palpable gynecomastia was present in 2% of the patient group, but not at all in the normal group. (2) Galactorrhea was not present in either patient or normal group. (3) The mean level of the serum prolactin in the group of patients without gynecomastia (n = 53) was significantly higher than that in the normal group (n = 35), but there was no significant difference in blood luteinizing hormone, follicle-stimulating hormone, testosterone (T), estradiol (E(2)) or T/E(2) ratio between the groups. (4) The mean level of the T/E(2) ratio in the patients with gynecomastia tended to be higher than that in the group of patients without gynecomastia. CONCLUSIONS: Overall, these results seem to indicate that (i) gynecomastia is not common in the Japanese population, and (ii) in male patients neither palpable gynecomastia nor galactorrhea is a common side effect of neuroleptics. To clarify the relation between gynecomastia and neuroleptic treatment, large prospective studies are required.

Journal Article↗
PubMedDate not supplied

Occult Leydig cell tumor in a patient with gynecomastia.

OBJECTIVE: To report a case of a clinically occult testicular tumor causing gynecomastia and to alert physicians to the importance of use of testicular ultrasonography in patients with progressive gynecomastia despite normal findings on testicular examination. METHODS: We present a detailed case, including results of clinical, laboratory, and radiologic assessment, of a man with hyperprolactinemia and gynecomastia. RESULTS: A 36-year-old man with progressive gynecomastia was referred to our clinic because of an increased serum prolactin level. Subsequent clinical investigation revealed no evidence of hypogonadism and several possible causes of the gynecomastia. Because of the patient's age and progressive symptoms, testicular ultrasonography was performed despite normal findings on testicular examination. This ultrasound study showed a right testicular mass, which proved to be a Leydig cell tumor. The patient was referred for definitive therapy with orchiectomy. Follow-up studies showed resolution of the gynecomastia and substantial decreases in prolactin and estradiol levels. CONCLUSION: Although gynecomastia is a relatively common disorder with a benign cause in most cases, physicians should be aware that normal findings on testicular examination do not completely rule out the possibility of a testicular tumor as the cause. Because of the potentially high morbidity of testicular tumors and their known association with gynecomastia, early performance of testicular ultrasonography in a patient with gynecomastia of unknown cause is advised.

Adult↗
PubMed2000

Gynecomastia-like lesions in the female breast.

CONTEXT: Gynecomastia is an abnormal enlargement of the male breast, but the histopathologic abnormalities could theoretically be present in female breasts as well. To my knowledge, however, there have been no reports in the literature to date that have attributed a clinically or radiologically detectable mass in a female breast exclusively to the histopathologic findings seen in gynecomastia. OBJECTIVE: The clinical, radiologic, and histopathologic findings of 4 patients with lesions composed exclusively of the findings of gynecomastia, herein termed gynecomastia-like lesions, are presented and compared with those of 3 patients with lesser degrees of these changes, herein termed gynecomastia-like areas, which were incidental accompaniments to other lesions. SETTING: During a 26-month interval, 1242 breast excisions (excluding needle biopsies or aspirates) were examined in a 170-bed, acute-care, community-medical school teaching hospital. RESULTS: Four patients had gynecomastia-like lesions varying from 1 to 3 cm in greatest dimension with histopathologic features showing the changes of gynecomastia exclusively. Two patients had clinically palpable masses. Two other patients had masses detected only by mammography. One postmenopausal patient was taking estrogen/progesterone replacement medication. Two of the 3 others were not taking birth control pills, and none had a clinical endocrinopathy. Thus far, none of the lesions have recurred. The 3 patients with gynecomastia-like areas were diagnosed separately with infiltrating ductal carcinoma, fibroadenoma, and lipoma. CONCLUSIONS: Pathologists should be aware that clinically palpable or radiologically detected masses in female breasts may be composed exclusively of the histopathologic findings of gynecomastia.

Adult↗
PubMed1985

Gynecomastia in testicular cancer patients. Prognostic and therapeutic implications.

Eighty-one patients with advanced testicular cancer were evaluated for gynecomastia or severe breast tenderness at diagnosis and after platinum-based chemotherapy. The prognostic significance of gynecomastia in these two settings was explored. At presentation, 10% (8 patients) had gynecomastia or breast tenderness and elevated HCG levels. The likelihood of gynecomastia was greater with increasing HCG level (P = 0.002). However, gynecomastia at presentation was a more powerful independent discriminant of poor survival than the initial HCG level by multivariate analysis (P = 0.004). Fifteen percent (12 patients) developed transient gynecomastia after chemotherapy not attributable to other known causes. HCG levels were normal. Endocrine evaluation typically revealed elevated FSH, LH, and estradiol/testosterone ratios. This may have reflected damage to testicular germinal epithelium. All 12 patients are alive without disease in contrast to the 8 patients who had gynecomastia at diagnosis. Therapy decisions should therefore be based on the time of onset of gynecomastia and in the context of appropriate clinical markers and evaluation.

Adolescent↗