ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P459 | DOI: 10.1530/endoabs.63.P459

Bilateral gynecomastia revealing a secreting adrenal adrenoma on a 5-year-old boy

Raoudha Kebaili1,2, Yosra Hasni2,3, Hajer Ben Belgacem1, Sana Alilech1, Samia Ben Hassan4, Amel Tej1,2, Koussay Eleuch2,3, Abdelatif Nouri4 & Lamia Boughamoura1,2

1Department of Pediatrics; Farhat Hached Hospital, Sousse, Tunisia; 2Faculté de Médecine Ibn el Jazzar, Sousse, Tunisia; 3Department of Endocrinology; Farhat Hached Hospital, Sousse, Tunisia; 4Department of Pediatric Surgery, Monastir, Tunisia.

Introduction: Gynecomastia is a benign proliferation of the human mammary gland that results from an imbalance between androgens and estrogens. It can be physiological at different stages of life (birth, adolescence, senescence) or secondary to drugs or diseases leading to androgen decline or estrogen elevation. We report a case of an important gynecomasty in a 5 year old boy.

Case report: A boy 5-year-old with no medical history consulted for a gynecomastia evolving since 2 years. On examination, he presented a statural advance and a voluminous bilateral gynecomastia stage B4 of Tanner. The external genitalia were normal and prepubar. The bone age was 7 years. Testicular ultrasound was normal. Abdominal ultrasound, supplemented by a CT scan, revealed a calcified adrenal mass of 2×3 cm. The investigations showed an estradiol level of 20 pg/ml; HCG, blood and urinary cortisol, T4, TSH and 17OHProgesterone were normal. The child had ablation of the adrenal tumor without incident. Histopathological examination revealed an adrenal adenoma. Three months later; we noticed a significant decrease in gynecomastia with a decrease in the value of blood estradiol.

Conclusion: Our observation is particular by the caricatural clinical presentation and the nature of the tumor since adrenal adenomas are exceptionally secreting.

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