CLINICAL EVALUATION OF GYNECOMASTIA
Anela Novak, Darko Kaštelan
Gynecomastia is characterized by the ennlargement of the male breast caused by glandular proliferation. Gynecomastia occurs when the estrogen-to-androgen ratio is disrupted, in plasma or locally in the breast tissue. The etiology is usually benign. Physiologic gynecomastia is common in newborns, adolescents, and older men. Nonphysiologic gynecomastia may be caused by chronic conditions (e.g. hypogonadism, liver cirrhosis, renal insufficiency), use of certain medications or substances, and, rarely tumors. The diagnostic evaluation starts with careful history taking and physical examination which may be followed by extensive work-up that includes selective imaging and laboratory testing. Discontinuing the use of contributing medications and treating the underlying disease are the mainstay of treatment.