- Commonest condition affecting male breast
- Due to enlargement of both ductal and stromal tissue
- It is benign and often reversible
- Usually presents as unilateral non-tender breast enlargement
Aetiology
- Most cases are idiopathic
- Physiological causes are due to relative oestrogen excess
- Physiological causes
- Pathological causes
- Primary Testicular Failure
- Anorchia
- Klinefelter's Syndrome
- Bilateral Cryptorchidism
- Acquired Testicular Failure
- Mumps
- Irradiation
- Secondary Testicular Failure
- Generalised hypopituitarism
- Isolated gonadotrophin deficiency
- Endocrine Tumours
- Testicular
- Adrenal
- Pituitary
- Non-Endocrine Tumours
- Bronchial carcinoma
- Lymphoma
- Hypernephroma
- Hepatic Disease
- Cirrhosis
- Haemochromatosis
- Drugs
- Oestrogens and oestrogen agonists - digoxin, spironolactone
- Hyperprolactinaemia - methyldopa, phenothiazines
- Gonadotrophins
- Testosterone target cell inhibitors - cimetidine, cyproterone Acetate
Management
- Reassurance that it is a benign and self-limiting condition
- Treatment of any underlying cause
- If painful or embarrassing consider subcutaneous mastectomy
- Performed through circumareolar incision
Bibliography
Colombo-Benkmann M, Buse B, Stern J, Herfarth C. Indications for and results of
surgical therapy for male gynecomastia. Am J Surg 1999; 178: 60-63.
Daniels I R, Layer G T. Gynaecomastia. Eur J Surg 2001; 167: 885-892.
Gasperoni C, Salgarello M, Gasperoni P. Technical refinements in the surgical treatment of
gynaecomastia. Ann Plast Surg 2000; 44: 455-458.
Glass A R. Gynecomastia. Endocrinol Metab Clin North Am 1994; 23: 825-837.
Williams
T G
Dawson P M.
Gynaecomastia - presentation, aetiology and management.
Current Practice in Surgery 1992; 4: 105 - 109.
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