Endocrinology Book

Sexual Development

  • Gynecomastia

Sweat Gland Disorders

http://www.fpnotebook.com/

GynecomastiaAka: Male Breast Enlargement, Benign Gynecomastia of Adolescence, Familial Gynecomastia

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  1. See Also
    1. Precocious Puberty
  2. Physiologic Cause in Newborn, Puberty, Older men
    1. Physiologic Mechanisms
      1. Estrogen excess
      2. Decreased androgen to Estrogen ratio
    2. Physiologic syndromes
      1. Gynecomastia in the newborn
        1. Common response to maternal Estrogens
        2. Breast enlargement usually resolves in weeks
        3. May be accompanied by milk discharge (witch's milk)
      2. Benign Gynecomastia of Adolescence
        1. Frequently occurs in boys at mid to late Puberty
        2. Asymmetric breast involvement and tenderness
        3. Resolves spontaneously within 1-2 years
      3. Familial Gynecomastia
        1. Common X-Linked recessive or dominant trait
        2. Limited breast development during Puberty
        3. No further evaluation unless Hypogonadism present
      4. Gynecomastia of aging
        1. Common in men over age 65 years (40-72%)
        2. Decreased androgen to Estrogen ratio
  3. Medication causes
    1. Cimetidine
    2. Spironolactone
    3. Nifedipine
    4. Verapamil
    5. Chemotherapeutics
    6. Phenothiazine
    7. Topical Estrogen exposure from sexual partner
  4. Illicit Drug use
    1. Male bodybuilder Tamoxifen use
    2. Anabolic Steroids
    3. Heroin
    4. Marijuana
    5. Methadone
  5. Other Pathologic causes
    1. Renal Failure
    2. Hyperthyroidism
    3. Congenital anorchia
    4. Klinefelter's Syndrome
    5. Primary tumor
      1. Adrenal tumor
      2. Testicular tumor
      3. Prolactin-secreting adenomas
    6. Ectopic hormone production
      1. Lung Cancer
      2. Stomach Cancer
      3. Liver cancer
      4. Kidney cancer
  6. References
    1. Wilson (1998) Williams Endocrinology, Saunders, 885-92
    2. Braunstein (1993) N Engl J Med 328:490
    3. Sher (1998) Clin Pediatr 37(6):367

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