Gynecomastia: a descriptive analysis

Mouna Elleuch; Oumeyma Trimeche; Salah Dhoha Ben; Wajdi Safi; Fatma Mnif; Majdoub Nabila Rekik; Mouna Mnif; Nadia Charfi; Faten Hadj Kacem; Abid Mohamed

doi:10.1530/endoabs.73.EP175

Introduction

Gynecomastia is the most common breast condition in men. The aim of our study is to describe clinical and therapeutic characteristics of patients with gynecomastia.

Methods

A descriptive retrospective study was conducted in the department of endocrinology at the Hedi Chaker hospital, Sfax, Tunisia.

Results

We collected the data of 28 patients with an average age of 37 years (extreme: 6 and 76 years) when having gynecomastia. Most patients presented spontaneously at the endocrinology office (53.3%). The rest were referred by other specialists. Five patients had a personal history of diabetes (17.9%), 3 had psychiatric disorder (10.7%).2 had a history of sterility (7.1%).1 had a renal failure, 1 was treated for hyperthyroidism, 1 had a bladder cancer and 1 subject had a Klinefelter disease. Symptoms associated with gynecomastia were hypogonadism in 39.3%, pituitary tumor syndrome in 3.6% and weight loss in 3.6%. The mean BMI was 29.4 ± 4.4 kg/m². Overweight and obesity were objected in 14.3% and 25% of patients respectively. Gynecomastia was bilateral for 18 patients (64.3%) and unilateral for 10 patients (35.7%) (left in 28.6% and right in 7.1%). No one in our group presented nipple discharge and only 2 had a painful gynecomastia. Gonadal examination was performed in 19 patients, and it was normal in 78.9% of them. Ectopic testicles were noted in 21.1% of cases. Laboratory tests showed hypergonadotropic hypogonadism in 35.5% of cases, hypogonadotropic hypogonadism in 14.3% and elevated PRL in 21.7%. Breast ultrasonography was performed in 35.7% of cases. The etiology was identified in 25 patients. The most common cause was physiological gynecomastia in 32% of cases, followed by drug induced gynecomastia in 24% (the drugs mostly incriminated were spironolactone, anti-depressants, omeprazole, chemotherapy). Treatment was conducted in only 10.7% of cases. The follow up of 22 of these patients showed a reduction in the volume of gynecomastia in 33.6% of cases and its disappearance in 66.7%.

Conclusion

Whereas in almost all the cases, gynecomastia has benign causes, it shouldn’t be ignored because it can hide life threatening diseases.

Endocrine Abstracts

EP175