Gynaecomastia

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Gynaecomastia

  1. 1. Gynecomastia Dr. Naila Awal
  2. 2. Definition • Enlargement of male breast due to hypertrophy & hyperplasia of both glandular & stromal component.
  3. 3. Pathogenesis Estrogen Activity (stimulate breast tissue) Androgen activity (counteracts that effect) Fig- Imbalance b/w estrogen & androgen
  4. 4. Cause • <25years of age- Hormonal pubertal change . ( During puberty, testosterone level varies. When testosterone levels are very low, higher levels of estrogen will affect the breast tissue, causing the breasts to grow larger )
  5. 5. • Later age- Testicular tumor-Leydig cell tumor, Sertoli cell tumor hCG secreting germ cell tumor Lung carcinoma Drugs- Alcohol Marijuana Heroine Anabolic steroid Hormonal- Klinefelter syndrome Idiopathic
  6. 6. Morphology Site- Usualy unilateral (Idiopathic & Drug medication) Bilateral –Pubertal & hormonal induced. Gross- Button like subareolar mass. (Carcinoma- ecentricaly) Oval, Disc shaped, well circumscribed. M/E- Micropapillary epithelial hyperplasia of duct Dense collagenous connective tissue Long duration- Prominent stromal fibrosis.
  7. 7. Gynecomastia
  8. 8. Outcome • In rare case, If intraductal epithelial hyperplasia is too extreme Stimulate carcinoma

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