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.
18 - 21 May 2019
European Society of Endocrinology