Gynaecomastia

Enlargement of the male mammary gland is termed gynaecomastia. Diagnosis and treatment of this andrological disorder usually fall to dermatologists, surgeons and primary care physicians. Gynaecomastia is found in men of different ages with frequency. The harmless pubertal gynaecomastia is as frequent as gynaecomastia of the elderly. Other forms are caused by an altered ratio of oestrogens to androgens, by hCG-producing tumours, and by hyperprolactinaemia. There is no correlation between cause and clinical appearance. Gynaecomastia is easy usually easily diagnosed by clinical examination; sonography and mammography may then be used for confirmation. Endocrine causes and hCG-producing tumours should be excluded by hormone analysis. Histological examination of the tissue is mandatory to exclude carcinoma of the breast. The prognosis of male breast carcinoma is not poorer than that of the female carcinoma. Pubertal gynaecomastia usually resolves spontaneously. Surgical removal is generally required in other forms, as conservative approaches are ineffective.