Gynaecomastia and tuberous breast
Gynaecomastia: Gynaecomastia is commonly described as benign ( Noncancer) proliferation of male breast tissue or persistant enlargement of male breast tissue.
32 to 36% of males suffer from gynaecomastia, and as high as 65% in adolescent boys.
Bilateral disease is reported to occur in 25-75% of cases
Causes of Gynaecomastia
1.Idiopatic- exact cause is not known.
Oestrogen,androgens ad their receptors are thought to play a major role in the development of the condition
An imbalance in the concentrations of the hormone’s, with a relative increase in ostrogen, is thought to bring about breast tissue proliferation.
A relative increase in plasma estradiol compared to testosterone is thought to cause pubertal gynecomastia.
In addition ,weight gain increases conversion of testosterone to ostrogen.
Due to various metabolic and endocrine disorders
Aquired and congenital hypogonadal states leading to an increased overall estrogen state.
Drugs are major etiological factor
It occurs due to direct increase in ostrogen and decreased testosterone
Bannayan and Hajdu
Cordova and Moschella
Opinion of Endocrinologist
Evaluation of liver,renal and thyroid function
Tumourmarkersfot testicular such as bhCG,alphaferoprotein and basal prolactin level(Prolactinoma)
X-ray chest to rule out ca lung
Mammmography: To rule out ca breast
CT head to rule out pituitary tumours.
Medical: Tab Tamoxifen(anti-oestrogen), TabClomiphen( act on hypothalamic pituitary axis to increase LH & FSH) and Tab Danazole( acts on by suppressing pituitary –ovarian axis by inhibiting the out put of both LH & FSH) can be used for spontaneous regression.
The aim of surgical treatmentare volume reduction with or without retailoring of redundant skin.