Massive chronic bilateral gynecomastia in a middle aged man: A case report

Abstract

Gynecomastia is defined as enlargement of the male breast and derives its origin from 2 Greek words- 'gyne' and 'mastos' which mean "woman's" "breast". Gynecomastia is a clinical condition and often has three radiological patterns which are nodular, dendritic and diffuse glandular patterns. We report a case of a 42 year old man of Hausa-Fulani descent with massive bilateral breast enlargement of multifactorial origin. Investigations done included thyroid function test, liver function test and additional basic blood workup. A mammogram was done, which was followed by breasts ultrasound. Additional radiological imaging included abdominal and testicular sonograms and diagnosis of massive bilateral gynecomastia was made. Anti-psychotics are a documented cause of gynecomastia while thyroid dysfunction is an often overlooked etiology of male breast enlargement. Medical treatment may address the underlying pathology in some cases; however, surgical reconstruction must be considered in severe, chronic cases as it addresses the physical deformity which is a significant cause of depression in these patients. The role of radiology in excluding the causes of gynecomastia cannot be overemphasized and is pertinent in the management of this condition.