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Gynecomastia clinical and surgery

Priya Vaidyanathan, Paul Kaplowitz
Pubertal gynecomastia is common, can be seen in 65% of the adolescent boys and is considered physiological. It is thought to be due to transient imbalance between the ratio of testosterone and estradiol in the early stages of puberty. It resolves in 1-2 years and requires no treatment. However, more persistent and severe pubertal gynecomastia is less common and can be associated with pathological disorders. These can be due to diminished androgen production, increased estrogen production or androgen resistance...
December 28, 2018: Endocrinology, Diabetes & Metabolism Case Reports
Erdal Eren, Ayça Törel Ergür, Şükriye Pınar İşgüven, Eda Çelebi Bitkin, Merih Berberoğlu, Zeynep Şıklar, Firdevs Baş, Servet Yel, Serpil Baş, Elif Söbü, Abdullah Bereket, Serap Turan, Halil Sağlam, Zeynep Atay, Oya Ercan, Tülay Güran, Mehmet Emre Atabek, Hüseyin Anıl Korkmaz, Aylin Kılınç Uğurlu, Ayşehan Akıncı, Esra Döğer, Enver Şimşek, Emine Demet Akbaş, Ayhan Abacı, Ülkü Gül, Sezer Acar, Eda Mengen Uçaktürk, Melek Yıldız, Edip Ünal, Ömer Tarım
OBJECTIVE: We aimed to study the characteristics on admission, diagnosis, treatment, and follow-up of hyperprolactinemic cases in a large multicenter study. METHODS: We reviewed 233 hyperprolactinemic patients under 18 years of age who were followed by different centers. The patients were divided as having microadenomas, macroadenomas, drug-induced hyperprolactinemia, and idiopathic hyperprolactinemia. Complaints of the patients and their treatment (medication and/or surgery) responses were evaluated in detail...
November 5, 2018: Journal of Clinical Research in Pediatric Endocrinology
Vanda F Torous, Stuart J Schnitt
Breast reduction surgery or mastectomy following administration of androgen therapy is part of the female-to-male gender reassignment process. Details regarding the histopathologic findings in breast tissue from patients undergoing female-to-male gender reassignment surgery are limited. We reviewed hematoxylin and eosin-stained sections of breast tissue from 148 patients who underwent breast reduction surgery or mastectomy as part of the female-to-male gender reassignment process at our institution between January 2014 and May 2017...
October 11, 2018: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Tim C van de Grift, Lian Elfering, Marijke Greijdanus, Jan Maerten Smit, Mark-Bram Bouman, Anne F Klassen, Margriet G Mullender
BACKGROUND: The effectiveness of gender confirming surgery is best evaluated on the basis of patient-reported outcomes such as appearance satisfaction and health-related quality of life. This is the first explorative study using the BODY-Q chest module, administered in trans men before and after mastectomy. METHODS: Between October 2016 and May 2017, trans men were recruited to participate in a cross-sectional study. Data collection included standardized anamnesis and examination, screening questions on depression/anxiety, and seven BODY-Q scales, including new scales measuring satisfaction of the chest and nipples...
August 7, 2018: Plastic and Reconstructive Surgery
Armaan K Malhotra, Shazhan Amed, Marija Bucevska, Kevin L Bush, Jugpal S Arneja
BACKGROUND: Primary evidence for the role of endocrinologic investigations in patients with adolescent gynecomastia is lacking in the current literature. The objective of this study was to assess the yield of endocrinologic investigations in the evaluation of adolescent gynecomastia to inform current practice for this common condition. METHODS: A 26-year retrospective review was conducted. Data collection included patients with gynecomastia presenting to endocrinology at a quaternary children's hospital with a catchment area of 1 million...
July 2018: Plastic and Reconstructive Surgery
Camila Nascimento Alves, Tiago Kiyoshi Kitabayashi Braga, Danusa Neves Somensi, Bruno Sérgio Vilhena do Nascimento, José Antônio Santos de Lima, Satomi Fujihara
The X-linked spinal and bulbar muscular atrophy (Kennedy's disease) is a rare X-linked, recessive, lower motor neuron disease, characterized by weakness, atrophy, and fasciculations of the appendicular and bulbar muscle. The disease is caused by an expansion of the CAG repetition in the androgen receptor gene. Patients with Kennedy's disease have more than 39 CAG repetitions. We report a case of 57-year-old man, resident of Monte Dourado (PA, Brazil) who complained of brachiocrural paresis evolving for 3 years along with fasciculations and tremors of extremities...
June 7, 2018: Einstein
Man Luo, Hong Peng, Min Song, Qianhui Zhou, Yaomei Long, Ping Chen
Primary mediastinal choriocarcinoma in male is not a very common disease, with nonspecific clinical manifestations. Gynecomastia and testicular atrophy are present in some cases. The levels of serum human chorionic gonadotropin are often significantly increased. Giant lump in the mediastinum and bilateral lungs multiple metastases can be seen on the computed tomography for lung. The diagnosis for it depends on pathological biopsy. Current treatment method is a comprehensive, consisting of chemotherapy, radiotherapy and surgery...
October 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
Jerry W Chao, Janani A Raveendran, Connor Maly, Gary Rogers, Michael Boyajian, Albert K Oh
BACKGROUND: In cases of refractory gynecomastia, surgical excision of excess glandular breast tissue is often warranted. Closed-suction drain placement is commonplace; however, the effect of drains on preventing complications after male breast surgery has not been fully elucidated in the literature. OBJECTIVE: To investigate the effect of drains on reducing seroma and hematoma after subcutaneous mastectomy for gynecomastia. METHODS: Retrospective chart review of patients undergoing subcutaneous mastectomy for gynecomastia over a 10-year period...
December 2017: Aesthetic Plastic Surgery
Farida Chentli, Fadila Chabour, Djafer Bouchibane, Nouria Nouar
Malignant feminizing adrenocortical tumors are exceedingly rare. Their main presentation is gynecomastia. In these estrogen secreting tumors (with or without other adrenocortical hormones) lack of gynecomastia is exceptional as in our case. A 44-year-old man presented with abdominal pain. Radiological assessment revealed a tumor measuring 120 × 95 mm in the retroperitoneal area with numerous metastases. Pathological examination pleaded for an adrenal origin with a Weiss's score of 5. Six months later, the tumor relapsed, and he had a second surgery and was sent for hormone assessment...
July 2017: Oman Medical Journal
Lazaro Cardenas-Camarena, Carlos Dorado, Maria Teresa Guerrero, Rosa Nava
INTRODUCTION: Aesthetic breast area improvements for gynecomastia and gender dysphoria patients who seek a more masculine appearance have increased recently. We present our clinical experience in breast masculinization and a classification for these patients. METHODS AND MATERIALS: From July 2003 to May 2014, 68 patients seeking a more masculine thorax underwent surgery. They were divided into five groups depending on three factors: excess fatty tissue, breast tissue, and skin...
June 2017: Aesthetic Plastic Surgery
A Fricke, G M Lehner, G B Stark, V Penna
BACKGROUND: "Gynecomastia" is an enlargement of the male breast. Our study aims to assess patient satisfaction as well as evaluate differences in recurrence rates in lipomatous and glandular gynecomastia 10-19 years postoperatively. METHODS: Forty-one gynecomastia patients undergoing surgical treatment from 1997 to 2005 were invited for a follow-up examination 10-19 years postoperatively. Of these, 16 patients presented for a clinical examination. Patient satisfaction was measured with a validated questionnaire [consultation satisfaction questionnaire (CSQ)-9]...
June 2017: Aesthetic Plastic Surgery
Mustafa Keskin, Mustafa Sutcu, Mustafa Hanci, Bulent Cigsar
BACKGROUND: One of the clinical aspects characterizing gynecomastia is the enlargement of the nipple-areolar complex (NAC) due to hypertrophic breast glands, and the excessive fatty tissue underneath. OBJECTIVE: The purpose of this study was to quantify the reduction of the areolar diameter after ultrasound-assisted liposuction (UAL) of the male breast. METHODS: The horizontal diameters of the NACs of 30 men who underwent UAL were measured before surgery, 1 month after surgery and 6 months after surgery in a standard fashion...
August 2017: Annals of Plastic Surgery
A Longheu, F Medas, F Corrias, S Farris, A Tatti, G Pisano, E Erdas, P G Calò
AIM: Gynecomastia is a common finding in male population of all ages. The aim of our study was to present our experience and goals in surgical treatment of gynecomastia. PATIENTS AND METHODS: Clinical records of patients affected by gynecomastia referred to our Department of Surgery between September 2008 and January 2015 were analyzed. 50 patients were included in this study. RESULTS: Gynecomastia was monolateral in 12 patients (24%) and bilateral in 38 (76%); idiopathic in 41 patients (82%) and secondary in 9 (18%)...
July 2016: Il Giornale di Chirurgia
Dae Hwa Kim, Il Hwan Byun, Won Jai Lee, Dong Kyun Rah, Ji Ye Kim, Dong Won Lee
BACKGROUND: The treatment of gynecomastia depends on multiple factors, and the best modality is controversial. In this study, we aimed to determine the best management approach by comparing outcomes of two groups of patients with gynecomastia who received subcutaneous mastectomy combined with liposuction and liposuction only. METHODS: We conducted a retrospective analysis of 64 patients who underwent surgery for gynecomastia. We divided the patients into two groups: group A, patients who underwent liposuction only; and group B, patients who underwent liposuction and subcutaneous mastectomy...
December 2016: Aesthetic Plastic Surgery
A Lucas-Herald, S Bertelloni, A Juul, J Bryce, J Jiang, M Rodie, R Sinnott, M Boroujerdi, M Lindhardt Johansen, O Hiort, P M Holterhus, M Cools, G Guaragna-Filho, G Guerra-Junior, N Weintrob, S Hannema, S Drop, T Guran, F Darendeliler, A Nordenstrom, I A Hughes, C Acerini, R Tadokoro-Cuccaro, S F Ahmed
BACKGROUND: In boys with suspected partial androgen insensitivity syndrome (PAIS), systematic evidence that supports the long-term prognostic value of identifying a mutation in the androgen receptor gene (AR) is lacking. OBJECTIVE: To assess the clinical characteristics and long-term outcomes in young men with suspected PAIS in relation to the results of AR analysis. METHODS: Through the International Disorders of Sex Development Registry, clinical information was gathered on young men suspected of having PAIS (n = 52) who presented before the age of 16 years and had genetic analysis of AR...
November 2016: Journal of Clinical Endocrinology and Metabolism
Anand Mohapatra, Aaron M Potretzke, Brent A Knight, Min Han, Robert S Figenshau
Granulosa cell tumors (GCTs) of the testis are rare sex cord-stromal tumors that are present in both juvenile and adult subtypes. While most adult GCTs are benign, those that present with distant metastases manifest a grave prognosis. Treatments for aggressive GCTs are not well established. Options that have been employed in previous cases include retroperitoneal lymph node dissection (RPLND), radiation, chemotherapy, or a combination thereof. We describe the case of a 57-year-old man who presented with a painless left testicular mass and painful gynecomastia...
2016: Case Reports in Urology
Ken Munene Nkonge, Emily Adhiambo Rogena, Edwin Owino Walong, Dennis Karani Nkonge
BACKGROUND: Palpable breast lump, breast pain, and nipple discharge are common symptoms of breast disease. Breast cytology (fine-needle aspiration, nipple discharge smear, and touch preparation) accurately identifies benign, atypical, and malignant pathological changes in breast specimens. This study aims to determine the types of breast lesions diagnosed by breast cytology and assess the clinical adequacy of narrative reporting of breast cytology results. METHODS: Medical records of 390 patients presenting to breast or general surgery clinics in Kenyatta National Hospital, Nairobi, Kenya, between January 2010 and March 2014 were evaluated retrospectively...
2015: BMC Women's Health
Roger J G Stevens, Samantha G Stevens, Jennifer E Rusby
INTRODUCTION: Action On Plastic Surgery (AOPS) criteria for funding of gynaecomastia surgery are: the patient should be post-pubertal, have a BMI ≤ 25 kg/m(2), endocrine and drug causes and breast cancer should be excluded and the patient should demonstrate psychological distress. We evaluated how NHS funding for gynaecomastia surgery varies between Clinical Commissioning Groups (CCGs) in England and whether there is a "postcode lottery". METHODS: The gynaecomastia surgery policies for 211 CCGs in NHS England were reviewed against the AOPS criteria and grouped according to their funding policies: group 1 (if criteria met, funding approved); group 2, (if criteria met, prior approval required); group 3 (no criteria, individual funding request only) and group 4 (no funding)...
October 2015: International Journal of Surgery
Chia-Sui Kao, Kristine M Cornejo, Thomas M Ulbright, Robert H Young
The clinical and pathologic features of 70 juvenile granulosa cell tumors (JGCTs) of the testis are presented. The patients were from 30 weeks gestational age to 10 years old; 60 of 67 (90%) whose ages are known to us were 6 months old or younger. Sixty-two underwent gonadectomy, 6 wedge excision, and 2 only biopsy. Twenty-six tumors were left sided and 22 right sided. Six occurred in an undescended testis and 2 in dysgenetic gonads. The most common presentation was a testicular mass (65%), followed by an "enlarging testis" (25%)...
September 2015: American Journal of Surgical Pathology
Aisha Al-Sinani, Waad-Allah S Mula-Abed, Manal Al-Kindi, Ghariba Al-Kusaibi, Hanan Al-Azkawi, Nahid Nahavandi
This is the first case report in Oman and the Gulf region of a 17-β-hydroxysteroid dehydrogenase type 3 (17-β-HSD3) deficiency with a novel mutation in the HSD17B3 gene that has not been previously described in the medical literature. An Omani child was diagnosed with 17-β-HSD3 deficiency and was followed up for 11 years at the Pediatric Endocrinology Clinic, Royal Hospital, Oman. He presented at the age of six weeks with ambiguous genitalia, stretched penile and bilateral undescended testes. Ultrasound showed no evidence of any uterine or ovarian structures with oval shaped solid structures in both inguinal regions that were confirmed by histology to be testicular tissues with immature seminiferous tubules only...
March 2015: Oman Medical Journal
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