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Transcript of GYNECOMASTIA
NAME : Abdelrhman elneanaey
NUM : 619
is the method of
choice for radiologic examination of
male breast tissue in the diagnosis of gynecomastia.
be distinguished from muscle
hypertrophy of the pectoralis
has recently been questioned due to
the rarity of breast cancer in
• Grade I: Minor enlargement, no skin excess
• Grade II: Moderate enlargement, no skin excess
• Grade III: Moderate enlargement, skin excess
• Grade IV: Marked enlargement, skin excess
- About 10%-25% of cases
result from the use of medications.
This is known as non-physiologic
GnRH analogues ,HGH , HCG.
inhibitors such as finasteride .
- Gynecomastia is caused by
excessive estrogen actions and is often the result of an
increased ratio of estrogen to androgen
- In approximately
of cases, the cause of gynecomastia is
Histological examination of tissue attained by fine needle aspiration cytology may demonstrate
dilated ducts with periductal fibrosis, increased subareolar fat, and hyalinization of the stroma
Gynecomastia is derived
from two terms
the term of gyneco which means the femal and the other term of mastia which means the breast.
- Also it may occurs in
Signs and symptoms
- It occur unilaterally or
bilaterally . patient may have :
Nipple discharge in one or
Increase in the diameter
of the areola
Conditions that interfere with
normal testosterone production,
can be associated with
Normal aging cause hormone changes such as testosterone.
This is also known as
and is typically found in men between
- Other tumors such as
Pituitary gland tumors
Bronchogenic carcinoma alters
the male-female hormone
Liver failure and cirrhosis
One of the most common cause
of gynecomastia .
The liver's ability to metabolize estrogen
Presence of phytoestrogens in alcohol may also cause a higher estrogen to testosterone ratio.
Those with alcoholic liver disease are put
at risk for development of gynecomastia .
Ethanol may disrupt the synthesis
Malnutrition and starvation
- Malnutrition cause :
testosterone levels drop .
the liver's ability to degrade estrogen
is diminished .
10-40% of individuals with hyperthyroidism may experience gynecomastia .
Returning to a normal thyroid state leads to resolution of the
a few months.
- Dialysis may attenuate
malnutrition of renal failure.
Weight loss can alter the condition, but losing weight will not reduce the glandular component and patients cannot target areas for weight loss.
Gynecomastia commonly presents in
( 50 ).
^ Jump up to: a b c Niewoehner, CB; Schorer, AE (March 2008). "Gynaecomastia and breast cancer in men". BMJ 336 (7646): 709–713. doi:10.1136/bmj.39511.493391.BE. PMC 2276281. PMID 18369226.
^ Jump up to: a b c d Shulman, DI; Francis, GL; Palmert, MR; Eugster, EA; Lawson Wilkins Pediatric Endocrine Society Drug and Therapeutics Committee (April 2008). "Use of aromatase inhibitors in children and adolescents with disorders of growth and adolescent development.". Pediatrics 121 (4): e975–983. doi:10.1542/peds.2007-2081. PMID 18381525.
Jump up ^ Iaunow, E; Kettler, M; Slanetz, PJ (March 2011). "Spectrum of disease in the male breast". American Journal of Roentgenology 196 (3): W247–259. doi:10.2214/AJR.09.3994. PMID 21343472.
Thyroid gland produces too
much of thyroxine and is thought
to influence the level of sex hormone binding globulin.
- Malabsorption conditions such
as cystic fibrosis or
ulcerative colitis .
- Gynecomastia can occur once normal nutrition resumes but usually resolves
within one to two years.
- Testicular tumors such as
Leydig cell tumors .
Sertoli cell tumors .
HCG-secreting choriocarcinoma .
- Renal failure cause
Suppression of testosterone
Testicular damage from high levels of urea
Growing glandular tissue by act of hormonal stimulation, is often tender or painful.
It can frequently present social and psychological difficulties.
benign enlargement of
breast tissue in males.
- It may occur transiently in newborns .
- Half or more of adolescent boys have some breast development during puberty.
- Other probable Medications include :
such as nifedipine,
Anabolic steroids , alcoholics.
Opioids, alkylating agents .
Androgen deprivation therapy .
Gynecomastia is not harmful , but in
some cases it may be an indicator
Massive weight loss can result in sagging tissues chest ptosis.
(30-60 %) male may exhibit sign of gynecomastia during their adolescence.
Most cases of adolescent gynecomastia resolve within six months to two years.