Sandbox: HS

Differential Diagnosis	Differentiating Features
Gynecomastia	Round discrete mass felt under areola and usually bilateral.
Pseudogynecomastia	Increased adipose rather than glandular tissue on examination.
Lipoma	Asymmetric breast enlargement.
Breast cancer	Nipple discharge, Axillary lymphadenopathy, usually nonpainful mass.
Sebaceous cyst	Asymmetric enlargement and swelling feels closer to skin.
Mastitis	Systemic s/s of infection.

ABC

def

DRUGS	MOA	SIDE
SDFA	SDFA	DSFA

papichulo

Based on the androgen and estrogen balance

• Decreased Testosterone

• Androgen-insensitivity syndrome
• Congenital anorchia
• Five alpha-reductase deficiency
• Hypopituitarism
• Kallman Syndrome
• Klinefelter Syndrome
• Renal Failure
• Testicular trauma
• Torsion of the testes
• Viral orchitis

• Increased Estrogens

• Adrenal cancer
• Chronic liver disease
• Extragonadal germ cell tumors
• Familial gynecomastia
• Hyperthyroidism
• Kidney carcinoma
• Liver cancer
• Lung carcinoma
• Malnutrition
• Other gastrointestinal (GI) tract carcinoma
• Stomach cancer
• Testicular cancer

references

{{{ stimulatory action }}}

{{{ Breast Tissue }}}

Inhibitory action

Right coronary artery

Androgens

Estrogen

Brachiocephalic a

R common carotid a

R subclavian a

L common carotid a

Internal carotid a

External carotid a

L subclavian a

Axillary a

Int. thoracic a

Progesterone (Thorax)

Bronchial as

Growth hormone and IGF-1

Celiac a

L gastric a

Common hepatic a

Splenic a

SMA

Renal as