Endocrine Abstracts

Gynecomastia is the most common disorder of the male breast.

The aim of the present study was to evaluate its progression with time in children with pubertal gynecomastia for a mean period of five years.

PATIENTS AND METHODS :25 boys without evidence of testicular or karyotype abnormalities were included in the study. Mean age was 13.01±1.8 yrs. Duration of the follow up in all patients varied from 1.2 to 5.5 yrs(mean 2.7yrs) after appearance of the first symptoms. Children were divided into 3 groups. Group A comprised 15 children with breast enlargement of less than 6cm (mild gynecomastia), Group B 5 children with 6-11 cm (moderate) and Group C 5 children with breast tissue of more than 11cm(severe ). All patients had bilateral breast development and none had received medical treatment. Patients with liver disease, thyroid dysfunction, history of drug ingestion and malignancy were excluded.

RESULTS: Mean duration of gynecomastia was 2.06±1.23 yrs. 4 patients(16%)had developed gynecomastia during genital size stage II, 10 (40%) during stage III, 7 (28%) during stage IV and 5 (20%) during stage V.

Analytically, Group A patients experienced complete regression of gynecomastia within 3 yrs (100%). In 3/15 (20%) of Group A boys complete regression occurred in one year while 7 (46.6%) showed complete regression in two years and 5/15 (33.3%) in three years. Complete regression also occurred in 1/4 (20%) of group B patients while partial regression in 4/5 (80%). Finally, in Group C patients partial gynecomastia regression was noticed in 3/5 (60 %) of children, with the remainder 2/5 (40% ) persisting for more than 4 yrs, requiring cosmetic surgery.

CONCLUSION

Mild gynecomastia regresses entirely in all patients, while moderate in only 20% after a 3 year duration. In contrast, severe gynecomastia which usually persists, requires cosmetic surgery in a large proportion of patients (40%).