Ginecomastia / Gynecomastia

O objetivo deste trabalho foi observar na literatura dados referentes à etiologia da ginecomastia, seu diagnóstico e aspectos radiológicos. A metodologia adotada foi a pesquisa bibliográfica sistematizada para a produção de um artigo de revisão, de modo a responder ao objetivo proposto. A ginecomastia pode ser dividida em fisiológica (neonatal, puberal e senil) e patológica (resultante da diminuição da ação da testosterona, ou do aumento da ação estrogênica, por mecanismo de indução por drogas, idiopática ou secundária a outras causas). O diagnóstico deve ser realizado através do exame físico, investigação endócrina e exames radiológicos, como a mamografia e a ultrassonografia. O tratamento está baseado na orientação, medicamentos e, em último caso, cirúrgico.(AU)

The objective of this study was to observe data in the literature regarding the etiology, diagnosis and radiological aspects of gynecomastia. The methodology included a systematic literature search to produce a review article in order to meet the objective. Gynecomastia can be divided into physiologic (neonatal, pubertal and senile) and pathological (due to decreased action of testosterone, increased estrogen action, drug?induced, idiopathic or due to other causes). The diagnosis could be made by physical examination, endocrine and radiological investigation, as mammography and ultrasound. The treatment is based on the guidance, medication and, ultimately, surgery.(AU)

Gynaecomastia; management and causative factors

To determine the causative factors and management of Gynaecomastia. Observational case series study. Surgical Unit-1 Bahawal Victoria Hospital Bahawalpur, from 1st January 200 till 31st December 2007. Thirty male patients having breast swelling were included in this study. Relevant history was obtained. Appropriate | physical examination was performed. Necessary investigations were done and after making a diagnosis appropriate treatment was done. A total of 30 patients were studied in the study period of 18 months. Those male patients who were having breast lesion other than benign enlargement [e.g. Ca. Breast, Breast/Abscess] were not included in the study. Necessary investigations were done. Subcutaneous I Mastectomy was performed. The most common age group developing gynaecomastia was of 20-30 years [60%]. Bilateral gynaecomastia was observed in 76.66% and unilateral gynaecomastia in 23.33%. Idiopathic gynaecomastia was observed in 73.33% cases. Medical treatment was given with tamoxifen 10mg twice a day for the period of three months in 6 case [20%] and this remained effective in 5 case [83.33%]. Subcutaneous mastectomy was performed in 17 cases [56.66%]. Post-operative complications were seen in 4 cases [23.52%], the most common complication being wound hematoma in 2 cases [11.76%]. Most of the patients [88.9%] were fully satisfied with the results of subcutaneous mastectomy. Gynaecomastia is the most common benign lesion of the male breast. As far as physiological gynaecomastia is concerned, patients should be observed for at least 2 years from the onset of their condition. In most of the cases spontaneous resolution occurs. Surgical treatment should be planned in whom spontaneous resolution does not occur. Surgery remains the mainstay of therapy and is frequently indicated for psychological and cosmetic reasons

Terapia médica de la ginecomastia con tamoxifeno. Influencia del volumen y duración de la ginecomastia en el resultado terapéutico / Influence of size and duration of gynecomastia on its response to treatment with tamoxifen

Background. Gynecomastia is treated when it is painful, there are psychosocial repercussions or it does not revert in less tan two years. It is treated with the antiestrogenic drug tamoxifen, but there are doubts about its effectiveness in high volume gynecomastias or in those lasting more than two years. Aim. To assess the effectiveness and safety of tamoxifen for gynecomastia and the influence of its volume and duration on the response to treatment. Patients and methods. Forty three patients with gynecomastia, aged 12 to 62 years, were studied. Twenty seven patients had a pubertal physiological gynecomastia, in eight it was caused by medications, in four it was secondary to hypogonadism, in three it was idiopathic and in one it was due to toxic exposure. Twenty patients had mastodynia and in 33, gynecomastia had a diameter over 4 cm. It lasted less than two years in 30 patients, more than two years in nine and four did not recall its duration. All were treated with tamoxifen 20 mg/dayfor 6 months. A follow up evaluation was performed at three and six months of treatment. Results. Mastodynia disappeared in all patients at three months. At six months gynecomastia disappeared in 26 patients (62 percent), but relapsed in 27 percent. All gynecomastias caused by drugs with antiandrogen activity disappeared. Fifty two percent of gynecomastias over 4 cm and 90 percent of those of less than 4 cm in diameter disappeared (p<0.05). Fifty six percent of gynecomastias lasting more than two years and 70 percent of those of a shorter duration disappeared (p=NS). Two patients had diarrhea or flushes associated to the therapy. Conclusions: Tamoxifen is safe and effective for the treatment of gynecomastia. Larger lesions have a lower response to treatment.