Gynecomastia refers to any condition where the volume of the male’s breast is expanded as an outcome of an increase in fat, ductal tissue, or stroma. Gyne and masto, which in Greek indicate feminine and breasts, respectively, are the roots of the phrase gynecomastia.
Birth, old age, and puberty are times of hormonal fluctuation when this disorder most frequently manifests itself. Steroid use, extreme obesity, pharmacological drugs, and medical diseases like kidney failure, hypogonadism, and liver failure are just a few of the various aetiologies for this syndrome.
However, idiopathic gynecomastia is the most common cause of patient presentation. This illness is treated by addressing the underlying cause, as well as through imaging, lab work, and, if required, surgical intervention.
Epidemiology
Within particular age ranges of adult males, gynecomastia is more prevalent. This illness can affect newborns until their hormonal imbalances return to normal.
Boys begin to experience adolescent hypertrophy at the age of 13, and it can extend into their early 20s. Men sixty-five years of age and over are again more likely to get this illness.
Anatomy
Pathophysiology
Adipose tissue and glandular breast tissue growth lead to gynecomastia. Estrogen is the hormone that causes both the expansion of glandular tissue and the inhibition of testosterone release. Luteinizing hormone, which triggers the release of testosterone from the testicles, is suppressed by estrogen. Gynecomastia is a result of this hormonal disequilibrium process.
It is believed that pubescent gynecomastia results from an imbalance that typically regresses throughout a time when testosterone levels rise due to estradiol rising more quickly than testosterone. Increases in estrogen, as well as decreases in testosterone, can result from medical diseases like malignancies of the testes, pituitary, and adrenal glands. Gynecomastia can develop in some boys as a result of these hormonal abnormalities.
In addition to the drugs listed above, disorders of the liver, adrenals, testes, and thyroid can result in imbalances. Gynecomastia has been classified as having three different types: intermediate, fibrous, and florid. The type is frequently correlated with how long the condition has existed. Florid gynecomastia typically manifests within the first 4 months of the disorder.
An elevation in ductal mucosa, as well as vascularity, defines this kind. After one-year, fibrous gynecomastia develops and is characterized by more stromal fibrosis and fewer ducts. After a year, there is thought to be a development of fibrous to florid intermediate gynecomastia, which is present.
Etiology
Gynecomastia typically has an idiopathic origin. Furthermore, it has now been demonstrated that it is related to testosterone and estrogen hormone abnormalities. A higher amount of maternal estrogen in the blood is assumed to be the cause of this condition’s temporary appearance at delivery.
Adolescent males may also experience this syndrome as a result of a testosterone and estradiol imbalance. The cause of hypertrophy in men over sixty-five years is assumed to be a drop in levels of testosterone and a change in the testosterone to estrogen ratio. Elderly men are also more likely to be using drugs that lead to gynecomastia.
This syndrome may be influenced by underlying health diseases such as obesity, breast carcinoma, thyroid disease, hypogonadism, adrenal illness, renal dysfunction, malnutrition, and liver cirrhosis. Pituitary, Adrenal gland, testicular, and lung tumors can affect hormonal problems, leading to imbalances and, eventually, gynecomastia.
Thiazides, digoxin, estrogen, theophylline, and phenothiazines are some of the medications which have been demonstrated to be associated with this illness. Additionally linked to this condition is the use of a few recreational drugs, notably marijuana.
Methotrexate, vinca alkaloids, alkylating agents, and imatinib are chemotherapeutic medications that have been linked to gynecomastia. However, the most widely used medications have estrogen-like properties, and they include finasteride, ketoconazole, cimetidine, and spironolactone.
Genetics
Prognostic Factors
Although gynecomastia does not pose a life-threatening risk, it can nonetheless be quite upsetting emotionally. Most instances don’t get resolved for months or even years.
Additionally, male breast carcinoma is also a concern for males with Klinefelter (genetic) syndrome. Gynecomastia causes depression, social isolation, a lack of interest in activities that require taking off one’s shirt, and poor self-esteem in young individuals.
Clinical History
Physical Examination
Age group
Associated comorbidity
Associated activity
Acuity of presentation
Differential Diagnoses
Laboratory Studies
Imaging Studies
Procedures
Histologic Findings
Staging
Treatment Paradigm
by Stage
by Modality
Chemotherapy
Radiation Therapy
Surgical Interventions
Hormone Therapy
Immunotherapy
Hyperthermia
Photodynamic Therapy
Stem Cell Transplant
Targeted Therapy
Palliative Care
Medication
Future Trends
Media Gallary
References
https://www.ncbi.nlm.nih.gov/books/NBK430812/
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Gynecomastia refers to any condition where the volume of the male’s breast is expanded as an outcome of an increase in fat, ductal tissue, or stroma. Gyne and masto, which in Greek indicate feminine and breasts, respectively, are the roots of the phrase gynecomastia.
Birth, old age, and puberty are times of hormonal fluctuation when this disorder most frequently manifests itself. Steroid use, extreme obesity, pharmacological drugs, and medical diseases like kidney failure, hypogonadism, and liver failure are just a few of the various aetiologies for this syndrome.
However, idiopathic gynecomastia is the most common cause of patient presentation. This illness is treated by addressing the underlying cause, as well as through imaging, lab work, and, if required, surgical intervention.
Within particular age ranges of adult males, gynecomastia is more prevalent. This illness can affect newborns until their hormonal imbalances return to normal.
Boys begin to experience adolescent hypertrophy at the age of 13, and it can extend into their early 20s. Men sixty-five years of age and over are again more likely to get this illness.
Adipose tissue and glandular breast tissue growth lead to gynecomastia. Estrogen is the hormone that causes both the expansion of glandular tissue and the inhibition of testosterone release. Luteinizing hormone, which triggers the release of testosterone from the testicles, is suppressed by estrogen. Gynecomastia is a result of this hormonal disequilibrium process.
It is believed that pubescent gynecomastia results from an imbalance that typically regresses throughout a time when testosterone levels rise due to estradiol rising more quickly than testosterone. Increases in estrogen, as well as decreases in testosterone, can result from medical diseases like malignancies of the testes, pituitary, and adrenal glands. Gynecomastia can develop in some boys as a result of these hormonal abnormalities.
In addition to the drugs listed above, disorders of the liver, adrenals, testes, and thyroid can result in imbalances. Gynecomastia has been classified as having three different types: intermediate, fibrous, and florid. The type is frequently correlated with how long the condition has existed. Florid gynecomastia typically manifests within the first 4 months of the disorder.
An elevation in ductal mucosa, as well as vascularity, defines this kind. After one-year, fibrous gynecomastia develops and is characterized by more stromal fibrosis and fewer ducts. After a year, there is thought to be a development of fibrous to florid intermediate gynecomastia, which is present.
Gynecomastia typically has an idiopathic origin. Furthermore, it has now been demonstrated that it is related to testosterone and estrogen hormone abnormalities. A higher amount of maternal estrogen in the blood is assumed to be the cause of this condition’s temporary appearance at delivery.
Adolescent males may also experience this syndrome as a result of a testosterone and estradiol imbalance. The cause of hypertrophy in men over sixty-five years is assumed to be a drop in levels of testosterone and a change in the testosterone to estrogen ratio. Elderly men are also more likely to be using drugs that lead to gynecomastia.
This syndrome may be influenced by underlying health diseases such as obesity, breast carcinoma, thyroid disease, hypogonadism, adrenal illness, renal dysfunction, malnutrition, and liver cirrhosis. Pituitary, Adrenal gland, testicular, and lung tumors can affect hormonal problems, leading to imbalances and, eventually, gynecomastia.
Thiazides, digoxin, estrogen, theophylline, and phenothiazines are some of the medications which have been demonstrated to be associated with this illness. Additionally linked to this condition is the use of a few recreational drugs, notably marijuana.
Methotrexate, vinca alkaloids, alkylating agents, and imatinib are chemotherapeutic medications that have been linked to gynecomastia. However, the most widely used medications have estrogen-like properties, and they include finasteride, ketoconazole, cimetidine, and spironolactone.
Although gynecomastia does not pose a life-threatening risk, it can nonetheless be quite upsetting emotionally. Most instances don’t get resolved for months or even years.
Additionally, male breast carcinoma is also a concern for males with Klinefelter (genetic) syndrome. Gynecomastia causes depression, social isolation, a lack of interest in activities that require taking off one’s shirt, and poor self-esteem in young individuals.
https://www.ncbi.nlm.nih.gov/books/NBK430812/
medtigo
Gynecomastia
Updated :
August 24, 2023
Gynecomastia refers to any condition where the volume of the male’s breast is expanded as an outcome of an increase in fat, ductal tissue, or stroma. Gyne and masto, which in Greek indicate feminine and breasts, respectively, are the roots of the phrase gynecomastia.
Birth, old age, and puberty are times of hormonal fluctuation when this disorder most frequently manifests itself. Steroid use, extreme obesity, pharmacological drugs, and medical diseases like kidney failure, hypogonadism, and liver failure are just a few of the various aetiologies for this syndrome.
However, idiopathic gynecomastia is the most common cause of patient presentation. This illness is treated by addressing the underlying cause, as well as through imaging, lab work, and, if required, surgical intervention.
Within particular age ranges of adult males, gynecomastia is more prevalent. This illness can affect newborns until their hormonal imbalances return to normal.
Boys begin to experience adolescent hypertrophy at the age of 13, and it can extend into their early 20s. Men sixty-five years of age and over are again more likely to get this illness.
Adipose tissue and glandular breast tissue growth lead to gynecomastia. Estrogen is the hormone that causes both the expansion of glandular tissue and the inhibition of testosterone release. Luteinizing hormone, which triggers the release of testosterone from the testicles, is suppressed by estrogen. Gynecomastia is a result of this hormonal disequilibrium process.
It is believed that pubescent gynecomastia results from an imbalance that typically regresses throughout a time when testosterone levels rise due to estradiol rising more quickly than testosterone. Increases in estrogen, as well as decreases in testosterone, can result from medical diseases like malignancies of the testes, pituitary, and adrenal glands. Gynecomastia can develop in some boys as a result of these hormonal abnormalities.
In addition to the drugs listed above, disorders of the liver, adrenals, testes, and thyroid can result in imbalances. Gynecomastia has been classified as having three different types: intermediate, fibrous, and florid. The type is frequently correlated with how long the condition has existed. Florid gynecomastia typically manifests within the first 4 months of the disorder.
An elevation in ductal mucosa, as well as vascularity, defines this kind. After one-year, fibrous gynecomastia develops and is characterized by more stromal fibrosis and fewer ducts. After a year, there is thought to be a development of fibrous to florid intermediate gynecomastia, which is present.
Gynecomastia typically has an idiopathic origin. Furthermore, it has now been demonstrated that it is related to testosterone and estrogen hormone abnormalities. A higher amount of maternal estrogen in the blood is assumed to be the cause of this condition’s temporary appearance at delivery.
Adolescent males may also experience this syndrome as a result of a testosterone and estradiol imbalance. The cause of hypertrophy in men over sixty-five years is assumed to be a drop in levels of testosterone and a change in the testosterone to estrogen ratio. Elderly men are also more likely to be using drugs that lead to gynecomastia.
This syndrome may be influenced by underlying health diseases such as obesity, breast carcinoma, thyroid disease, hypogonadism, adrenal illness, renal dysfunction, malnutrition, and liver cirrhosis. Pituitary, Adrenal gland, testicular, and lung tumors can affect hormonal problems, leading to imbalances and, eventually, gynecomastia.
Thiazides, digoxin, estrogen, theophylline, and phenothiazines are some of the medications which have been demonstrated to be associated with this illness. Additionally linked to this condition is the use of a few recreational drugs, notably marijuana.
Methotrexate, vinca alkaloids, alkylating agents, and imatinib are chemotherapeutic medications that have been linked to gynecomastia. However, the most widely used medications have estrogen-like properties, and they include finasteride, ketoconazole, cimetidine, and spironolactone.
Although gynecomastia does not pose a life-threatening risk, it can nonetheless be quite upsetting emotionally. Most instances don’t get resolved for months or even years.
Additionally, male breast carcinoma is also a concern for males with Klinefelter (genetic) syndrome. Gynecomastia causes depression, social isolation, a lack of interest in activities that require taking off one’s shirt, and poor self-esteem in young individuals.
https://www.ncbi.nlm.nih.gov/books/NBK430812/
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