Gynecomastia differential diagnosis

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Husnain Shaukat, M.D [2]

Overview

Gynecomastia must be differentiated from other diseases that cause breast enlargement in men. These diseases include pseudo gynecomastia, breast cancer, breast abscess, and lipoma.

Differentiating Gynecomastia from other Diseases

Gynecomastia can be differentiated from other pathologies by detailed history taking and physical examination.^[1]^[2]^[3]

Diseases	Laboratory Findings			Physical Examination					History and Symptoms
Diseases	Estrogen-to-androgen ratio	Cholesterol levels	WBC count	Tenderness	Enlargement	Nipple discharge	Lymphadenopathy	Other physical exam findings	Age of onset	Medication intake
Gynecomastia	↑	N/A	-	+/-	+	+/-	N/A	Round discrete mass felt under areola and usually bilateral	Physiological gynecomastia is seen in newborns, adolescents and elderly	Pharmacological gynecomastia has hx of medication intake.
Pseudo gynecomastia	Normal	N/A	N/A	+/-	+	+/-	N/A	Increased adipose rather than glandular tissue on examination
Breast Cancer	N/A	N/A	N/A	+/-; mostly painless	+	+	+	Usually painless mass	Middle age to elderly
Lipoma	N/A	↑	N/A	+/-	+	+/-	N/A	Soft and mobile	Middle age to elderly
Sebaceous cyst	N/A	N/A	N/A	+/-	+	+/-	+/-	Asymmetric enlargement and swelling feels closer to the skin
Mastitis	N/A	N/A	↑	Tender	+/-	+/-	+/-	Systemic clinical features of infection

References

↑ Dickson G (2012). "Gynecomastia". Am Fam Physician. 85 (7): 716–22. PMID 22534349.
↑ Croes K, Baeyens W, Bruckers L, Den Hond E, Koppen G, Nelen V; et al. (2009). "Hormone levels and sexual development in Flemish adolescents residing in areas differing in pollution pressure". Int J Hyg Environ Health. 212 (6): 612–25. doi:10.1016/j.ijheh.2009.05.002. PMID 19546029.
↑ Laituri CA, Garey CL, Ostlie DJ, St Peter SD, Gittes GK, Snyder CL (2010). "Treatment of adolescent gynecomastia". J Pediatr Surg. 45 (3): 650–4. doi:10.1016/j.jpedsurg.2009.11.016. PMID 20223338.

[pmid22534349-1] Dickson G (2012). "Gynecomastia". Am Fam Physician. 85 (7): 716–22. PMID 22534349.

[pmid19546029-2] Croes K, Baeyens W, Bruckers L, Den Hond E, Koppen G, Nelen V; et al. (2009). "Hormone levels and sexual development in Flemish adolescents residing in areas differing in pollution pressure". Int J Hyg Environ Health. 212 (6): 612–25. doi:10.1016/j.ijheh.2009.05.002. PMID 19546029.

[pmid20223338-3] Laituri CA, Garey CL, Ostlie DJ, St Peter SD, Gittes GK, Snyder CL (2010). "Treatment of adolescent gynecomastia". J Pediatr Surg. 45 (3): 650–4. doi:10.1016/j.jpedsurg.2009.11.016. PMID 20223338.

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Gynecomastia differential diagnosis

Overview

Differentiating Gynecomastia from other Diseases

References

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