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Characteristics of the patient with gynecomastia
Which are the characteristics of the patient with gynecomastia?
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In adolescent boys, a small subareolar button that tends to harden may occur. In most adolescent patients gynecomastia will recede with age. |
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When this condition persists after puberty, it may be attributed to hypertrophy of breast tissue, chest adipose tissue, or a combination of both of them. |
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This condition is often tender or painful. The symptoms may persist for weeks or months. |
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It is sometimes difficult to differentiate between fatty tissue and breast tissue in obese patients. Most obese patients with enlarged breasts do not suffer from gynecomastia. A thorough physical evaluation is recommended to avoid misdiagnosis of gynecomastia in obese patient. |
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In most cases of pseudogynecomastia, this condition resolves spontaneously in time, and surgery is not considered. Gynecomastia is often related to a hormonal imbalance and the use of some medications. |
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Men who suffer from gynecomastia feel frustrated about their chests´ appearance. In adolescent boys this condition may cause anxiety, introspection and especially depression.
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Possible causes for gynecomastia
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Hormonal disorders. |
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Some medications may cause gynecomastia. |
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Certain testicular tumors may cause gynecomastia. |
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Renal disease. |
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Men with Klinefelter´s syndrome may present gynecomastia. |
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Gynecomastia is a potential adverse effect in men with prostate cancer, who are receiving estrogen therapy. |
Most cases of enlarged male breasts are related to obesity which is not associated with gynecomastia. Since misdiagnosis may occur in some cases, the treating physician should verify the gynecomastia characteristics through a complete examination, in order to confirm the diagnosis of this condition.
Evaluation
During consultation the following conditions will be evaluated:
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1 |
Time of appearance of gynecomastia. |
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Level of pain with or without tenderness on palpation. |
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Evolution of this condition since its appearance. |
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Unilateral or bilateral gynecomastia. |
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Clinical assessment for diagnosing androgen (male sex hormone) deficiency. |
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Assessment of the medications and drugs taken by the patient. |
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History of malnutrition. |
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Renal, cardiac, liver, or pulmonary disease existence. |
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Clinical assessment of possible testicular disease. |
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Clinical assessment of symptoms associated with estradiol, thyroxine, cortisol, prolactin, and GH (growth hormone) excess. |
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Assessment of thoracic trauma. |
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Family history of gynecomastia. |
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Laboratory analyses and diagnostic tests
Your physician may possibly recommend some of the following analyses to verify the gynecomastia diagnosis:
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Mammography and/or ultrasound scan. |
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Hormonal laboratory analyses. |
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Chromosome analysis. |
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Breast puncture. |
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Esticular ultrasound scan. |
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