Endocrine Abstracts

Objective: To describe a 32-year-old patient presenting to endocrine clinic as painful gynecomastia.

Method: We present clinical and radiological course of a rare case of gynecomastia secondary to HCG producing lung tumour.

Result: A 32-year-old patient presented to endocrine clinic with symptoms of painful lumpiness of nipples for the last 6 months. There is no history of any milk or blood discharge from the nipples and he has not noticed any other lumps in his body. He is not taking any regular medications. He does regular exercise and denied any steroid intake. There is no history of any weight loss. There are no testicular lumps. There is a history of increase hair growth and acne of his chest and back. On examination, no palpable mass felt in his testes and he was having bilateral gynecomastia.

His hormonal profile showed markedly raised testosterone, oestradiol, high 17-hydroxyprogesterone and beta HCG. His LH and FSH was suppressed.

CXR showed right ung mass and CT thorax showed right lung tumor possible carcinoid awaiting biopsy under respiratory physicians.

Conclusion: Although gynecomastia is a common disorder, hormonal work-up including hCG beta subunit should be done in an adult male patient presenting with rapidly progressing or recent onset of painful gynecomastia. Lung cancer should be considered in the differential diagnosis of gynecomastia attributable to ectopic production of hCG beta subunit.