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Slovenska pediatrija 2017; 24: 162-170

https://doi.org/

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Case report

GynAecomastia – REVIEW ARTICLE AND CASE REPORT OF PREPUBERTAL GYNAECOMASTIA

A. Pungartnik
Območna enota za varstvo otrok in mladine, Zdravstveni dom dr. Adolfa Drolca Maribor, Maribor, Slovenija

M. Krajnc
Območna enota za varstvo otrok in mladine, Zdravstveni dom dr. Adolfa Drolca Maribor, Maribor, Slovenija

N. Bratanič
Klinični oddelek za endokrinologijo, diabetes in bolezni presnove, Pediatrična klinika, Univerzitetni klinični center Ljubljana, Ljubljana

Abstract

Gynaecomastia is a benign proliferation of the breast glandular tissue in men. It is a frequent finding in adolescence, when there is an imbalance of sex hormones at the beginning of puberty. In rare cases, it can be caused by a serious illness. This must be considered especially in prepubertal gynaecomastia or in the presence of symptoms and clinical signs of an underlying disease. Clinically, it may be asymptomatic or it may cause mild problems (tension, discomfort) or pain. Adolescents with gynaecomastia often have problems with self-esteem. A detailed history and careful clinical examination often disclose the aetiology of gynaecomastia. In unclear cases, an ultrasound examination or mammography can be helpful. When deciding about treatment, the aetiology, duration and presence of symptoms or a troublesome appearance should be taken into account. Mostly, observation alone is enough in physiological gynaecomastia in adolescent boys. Pharmacological therapy is not used in Slovenia. In certain cases, such as persistent gynaecomastia, troublesome appearance or psychological disturbance, surgical treatment is considered.In the article, we present a boy who presented with progressive prepubertal gynaecomastia and tall stature in association with Peutz-Jeghers syndrome, probably as a consequence of a Sertoli cell tumour.

Key words: Key words: gynaecomastia, puberty, Peutz-Jeghers syndrome, Sertoli cell tumour, aromatase.