Background: A case report of Nigeria male who presented on account of bilateral gynaecomastia and was found to be azoospermic on investigation with a view to draw attention of clinicians to underling endocrine problems associated with gynaecomasia.
Methodology: A case report of a 32 year old Nigeria man with progressive-bilateral breast enlargement was reviewed.
Case report: A 32 year old Nigeria male with bilateral breast enlargement since 2013 presented to the endocrine clinic on account of the progressive increase in size of the breast which was protruding from his cloth. There was positive history of occasional pain from the breast. No history suggestive of kidney, thyroid nor liver diseases. No history of use of recreational drugs nor any other drugs. Does not smoke but occasionally takes alcohol. No history of erectile dysfunction orprevious surgery to the pelvic region. Had similar problem at age of 18 years for which he was given some drugs by a nurse.
On examination, the breasts were enlarged 3.5 cm bilaterally and there were testicular atrophy (5 ml with orchidometer). Other physical examinations were normal.
Investigations showed elevated LH, FSH and prolactin with normal testosterone, estradiol, bHCG, liver function test and electrolyte and creatinine. Testicular ultrasound shows bilateral testicular atrophy with varicocele and semen analysis was azoospermic. MRI shows pituitary micoadenoma.
Patient was commenced on carbegoline and refers to the urologist for surgery. He was to continue with drugs and come back for hormonal assays and seminal analysis.
Conclusion: Early referral of patients with gynaaemosia to endocrine clinic is necessary for adequate clinical and biochemical assessment to determine the cause and prompt treatment to prevent irreversible complications.