Gynaecomastia

Case contributed by Dr Ali Abougazia

Presentation

Left breast lump with occasional pain. Can't remember onset, duration or if there were any trauma.

Patient Data

Age: 53
Gender: Male
Mammography
A left breast subareolar flame shaped lesion is noted.
No left breast macro- or micro-calcific foci.
Normal skin thickness and contour of left breast.Normal areola / nipple complex of left breast.
Ultrasound
Left breast shows subareolar hypoechoic volcano-like mass lesion measuring 2.8 X 1.2 cm.
Normal right breast parenchyma with no evidences of solid or cystic masses.
Right axillary lymph nodes are noted retaining ovoid shape and fatty hila.
No enlarged right axillary lymph nodes.

Case Discussion

These findings are consistent with left breast gynaecomastia.

Gynaecomastia refers to enlargement of the male breast and is the most common male breast abnormality. It occurs most commonly in adolescent boys and older men men (>50 years). It has a variety of causes including drugs, functioning testicular tumors, liver cirrhosis. It's known to commonly be unilateral or assymetrical bilateral in location.

In this case, the main differential diagnosis would be male breast carcinoma. However, the perfect subareolar location and classic flame-shaped density of the lesion exclude malignancy, which would otherwise be more eccentric in location, irregular in shape and may show ill-defined or spiculated margins. Also male breast carcinoma is very rare and has higher mean age (around 70 years).

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Case information

rID: 23657
Case created: 30th Jun 2013
Last edited: 16th Jun 2016
System: Breast
Inclusion in quiz mode: Included

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