Gynecomastia differential diagnosis: Difference between revisions

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! colspan="3" |Laboratory Findings
! colspan="3" |Laboratory Findings
! colspan="4" |Physical Examination
! colspan="4" |Physical Examination
!
! rowspan="2" |Other physical exam findings
! colspan="2" |History and Symptoms
! rowspan="2" |Age of onset
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
|- style="background: #4479BA; color: #FFFFFF; text-align: center;"
!Estrogen-to-androgen ratio
!Estrogen-to-androgen ratio
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!Nipple discharge
!Nipple discharge
!Lymphadenopathy
!Lymphadenopathy
!Other physical exam findings
!Age of onset
!Medication intake
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gynecomastia]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Gynecomastia]]
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| style="background: #F5F5F5; padding: 5px;" |
* Physiological gynecomastia is seen in newborns, adolescents and elderly
* Physiological gynecomastia is seen in newborns, adolescents and elderly
| style="background: #F5F5F5; padding: 5px;" |
* Pharmacological gynecomastia has hx of medication intake.
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pseudo  gynecomastia
| style="background: #DCDCDC; padding: 5px; text-align: center;" |Pseudo  gynecomastia
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* Increased [[adipose]] rather than [[glandular]] tissue on examination
* Increased [[adipose]] rather than [[glandular]] tissue on examination
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Any age
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Breast cancer|Breast Cancer]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Breast cancer|Breast Cancer]]
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| style="background: #F5F5F5; padding: 5px;" |
* Middle age to elderly
* Middle age to elderly
| style="background: #F5F5F5; padding: 5px;" |
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lipoma]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Lipoma]]
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Middle age to elderly
* Middle age to elderly
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|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sebaceous cyst]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Sebaceous cyst]]
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* Asymmetric enlargement and swelling feels closer to the skin
* Asymmetric enlargement and swelling feels closer to the skin
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| style="background: #F5F5F5; padding: 5px;" |
| style="background: #F5F5F5; padding: 5px;" |
* Any age
|-
|-
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mastitis]]
| style="background: #DCDCDC; padding: 5px; text-align: center;" |[[Mastitis]]
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* Systemic clinical features of infection
* Systemic clinical features of infection
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| style="background: #F5F5F5; padding: 5px;" |
* Any age
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|}
|}


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}

Revision as of 23:24, 15 November 2017

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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 cancerbreast 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 Other physical exam findings Age of onset
Estrogen-to-androgen ratio Cholesterol levels WBC count Tenderness Enlargement Nipple discharge Lymphadenopathy
Gynecomastia N/A - +/- + +/- N/A
  • Round discrete mass felt under areola and usually bilateral
  • Physiological gynecomastia is seen in newborns, adolescents and elderly
Pseudo gynecomastia Normal N/A N/A +/- + +/- N/A
  • Any age
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
  • Any age
Mastitis N/A N/A Tender +/- +/- +/-
  • Systemic clinical features of infection
  • Any age

References

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