Aromatase excess syndrome presenting with prepubertal gynecomastia in an Egyptian child with type 1 neurofibromatosis.

A romatase excess syndrome (AEXS) is a rare autosomal dominant disorder characterized by prepubertal gynecomastia, it responds well to medical treatment. In the absence of prompt suspicion, it can expose the patient to the risk of unnecessary surgical intervention. Up to our best knowledge, the association between AEXS and neurofibromatosis type 1 (NF1) was not reported before. Here, we describe a AEXS presenting with prepubertal gynecomastia in an Egyptian child with NF1 that improved with aromatase inhibitors.

Breast diseases in Southern Yemen

To investigate the magnitude of breast diseases, and its frequency distribution in different age groups in Hadramout, Yemen. This is a prospective study conducted at the Central Laboratory of Ibn-Sinna Hospital Hadramout, Yemen from January 2006 to December 2009. Patients attending surgical units for breast problems were eligible. Patients were assessed clinically and referred to the laboratory center to confirm the diagnosis by histopathology. The data were collected from the patients and referral sheets. A total of 635 cases of breast disease were diagnosed. This includes 604 female and 31 male patients. Benign breast diseases [BED] was the most common lesion found in this study comprising 493 cases [77.6%], and 142 [22.4%] comprised malignant cases. Among BBD, the most common lesion was fibroadenoma [40.5%] followed by fibrocystic changes [16%], other benign breast lesions [10%], and inflammatory lesion [8%]. The age groups affected by BBD were: 20-29 years for fibroadenoma; 30-39 years for fibrocystic change; 20-29 years for other benign breast lesions; and 30-39 for inflammatory lesions, and carcinoma of the breast was common in the 40-49 age group. The left breast was affected in 331 [52%] cases, the right in 283 [45%], while in 3%, both breasts were affected. Fibroadenoma was the most frequently diagnosed benign breast lesion in Hadramout. An educational program is needed to alert patients of the significance of breast masses

Breast diseases; spectrum in Wah Cantt; POF hospital experience

To find out the magnitude of breast diseases and their distribution in different age groups among the patients attending surgical OPD for surgical consultation at POF Hospital Wah Cantt. This is a retrospective observational type of study. Patients attending surgical OPD for breast problem from January 2000 to December 2007 were included. They were assessed clinically and their diagnosis was confirmed by cytological [FNAC] or histopathological [biopsy] examination. Records were taken from pathology and surgery department and the patients were retrospectively reviewed. 954 cases of breast disease were diagnosed. These include 905 female and 49 male patients. Benign breast diseases [BBD] were the most common lesions of the breast found in this study [71.5%] whereas malignant lesions were on the rise with each passing year [28.5%]. Among BBD, the most common lesion was fibroadenoma [49%] followed by breast abscess [13%], Fibrocystic disease [9.3%] and gynecomastia [6.8%]. 271 cases [28.5%] were malignant lesions. This includes 269 female and 2 male cases. The common ages for BBD were, 12-30 years for fibroadenoma, 15-40 years for breast abscess, 18-40 years for fibrocystic disease and 15-29, 50-59 for gynecomastia respectively, whereas carcinoma breast was seen in the age group of fifties initially, getting more common in forties, in the later part of study. We conclude from this study that BBD is the most frequent breast ailment. Among the BBD, fibroadenoma was the most common lesion. Breast carcinoma cases were becoming more frequent but reached hospital at a late stage of the disease. Infiltrating ductal carcinoma was the most common malignancy noted

Relação da ginecomastia puberal com o índice de massa corporal em amostra de adolescentes atendidos em Unidade de Pacientes Externos de Hospital Universitário / The relation between pubertal gynecomastia and body mass index in a sample of adolescents attended at the Outpatient Health Unit of a University Hospital

OBJETIVO: Avaliar a associação entre a ginecomastia puberal e o índice de massa corporal (IMC) por idade. MÉTODOS: Uma amostra de 109 casos de indivíduos com idades de 11 a 19 anos foi selecionada na unidade ambulatorial de adolescentes do Hospital Universitário Pedro Ernesto, no período de 2003 a 2006. Os dados antropométricos coletados foram: peso, altura, diâmetro mamário e estágio de maturação sexual. A análise do IMC por idade foi baseada no NHANES I e nos pontos de corte de Cole para sobrepeso e obesidade. O nível de significância foi de p < 0,005. RESULTADOS: A porcentagem de adolescentes com sobrepeso e obesidade foi de 50,4%. O diâmetro mamário aumentou de 1,5 ± 1,0 a 4,86 ± 2,20 cm, mostrando correlação significante com os percentis do IMC por idade (Pearson = 0,59). CONCLUSÕES: O estudo confirmou a correlação significante do diâmetro mamário com os percentis de IMC, demonstrando a associação entre a ginecomastia puberal e IMC mais altos.

OBJECTIVE: To evaluate the association between pubertal gynecomastia and body mass index for age. METHODS: A sample of 109 cases was selected from the adolescent outpatient health unit, with ages between 11 and 19 years old at Pedro Ernesto University Hospital. Anthropometric measures of weight, height, mammary horizontal diameter and sexual maturation stage were collected. The analysis of the body mass index for age was based on the NHANES I and cutt-off points of Cole. The significance level was p < 0.005. RESULTS: The percentage of adolescents with overweight and obesity was 50.4%. The mammary diameters increased from 1.5 ± 1 to 4.86 ± 2.20 cm, with significant correlation to body mass index for age (Pearson = 0.59). CONCLUSIONS: The study confirmed significant correlation of mammary diameters to BMI percentiles and demonstrated that pubertal gynecomastia is associated with a higher IMC.

Ginecomastía: aproximación clínica y terapeútica / Gynecomastia: clinical and therapeutic approach

La Ginecomastia es una condición frecuente especialmente en la pubertad y edad adulta, no obstante en ocasiones produce en el paciente un importante grado de ansiedad y discomfort social. Si bien la mayoría de las veces no representa un desafío clínico diagnóstico, puede ser la manifestación inicial de un gran numero de condiciones médicas de mayor importancia para el pronóstico del paciente. De capital importancia es el diagnóstico diferencial con el cáncer de mama masculino, que si bien es de presentación mas bien excepcional, puede ser resuelto con un tratamiento precoz. El presente articulo es una revisión de los aspectos más trascendentes a considerar en el enfrentamiento clínico y terapéutico de esta condición.

Síndrome de Klinefelter: presentación de 18 casos / Klinefelterïs syndrome: presentation of 18 cases

Se revisan los aspectos clínicos y de laboratorio de 18 pacientes con síndrome de Klinefelter. El síndrome de Klinefelter es la causa congénita más frecuente de hipogonadismo hipergonadotropo y afecta a 1 de cada 500 varones. El diagnóstico se sospecha en un adolescente que falla en progresar en forma normal durante la pubertad y cuyos testículos son pequeños y firmes. El diagnóstico se confirma al encontrar gonadotrofinas elevadas y en en el cariotipo un cromosoma X extra. El diagnóstico precoz permite instaurar un tratamiento a los 11 o 12 años, permitiendo que la pubertad progrese en armonía, con la de sus pares y evita el riesgo de osteoporosis a futuro. En adultos, el tratamiento con enantato de testosterona o parches transdérmicos ejerce efectos positivos en la masa ósea, muscular y en la libido

Algunos aspectos del desarrollo sexual en adolescentes varones de 10 a 14 años / Certain aspects of sexual development in male adolescents aged 10-14 years

Se tomó una muestra aleatoria estratificada de 160 jóvenes varones de 10 a 14 años, procedentes del Area de Salud del Policlínico Docente de Playa, y se sometió a estudio entre los meses de julio y agosto de 1981, con el objetivo de conocer las características de inicio, secuencia y asociación de algunas variables del desarrollo sexual entre sí y con la edad y la raza, así como la prevalencia de acné juvenil y ginecomastia. Se halló una amplia variabilidad en las características del desarrollo sexual en los grupos de edades que se estudiaron, con una edad promedio de inicio puberal hacia finales de los 11 años y comienzo de los 12; todos exhibían a los 14 años signos de desarrollo sexual. Se demuestra que el desarrollo genital va más adelantado que el del vello pubiano. Se establecen las medianas del volumen testicular para cada estadio de desarrollo genital y grupo de edades. Se comprobó la asociación altamente significativa entre edad y grado de desarrollo sexual y no significativa entre éste y la raza, y se estableció la media y la mediana de los estadios de desarrollo para cada edad y raza. Se encontró que el acné juvenil aparece en etapas más tardías del desarrollo sexual en relación con la ginecomastia. La prevalencia de acné juvenil y ginecomastia a los 14 años fue del 25 y 22,5 % respectivamente

Anomalías de desarollo sexual en Puerto Rico: estado de situación / Abnormalities of sexual development in Puerto Rico: status report

Puerto Rico presenta el mayor número de casos conocidos de anomalias de desarrollo sexual en infantes, niños y adolescentes. Los autores han evaluado sobre 3100 pacientes en un período aproximado de 19 años. Diversos estudios clínicos y de laboratorio sugieren una posible contaminación de carnes, pollo y derivados de éstos con sustancias estrogénicas. Una dieta modificada, libre de estos alimentos, causa una mejoría clínica y/o de laboratorio en un número significativo de pacientes. Un estudio preliminar en alimentos utilizados en el engorde de pollos sugiere la contaminación por Fusarium sp, hongo que puede producir micotoxinas con efecto estrogénico. Al presente, diversos investigadores, privados y de gobierno, llevan a cabo diversos estudios. Sin embargo, se precisa de una acción más vigorosa y fiscalizadora. Consideramos imprescindible un estudio específico de los alimentos de engorde para determinar la presencia de contaminantes con efecto hormonal. La persistencia de estas anomalías debe deterner-se por sus posibles consecuencias a largo plazo