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Gynecomastia, Pediatric

Chirag R. Kapadia, MD and Zoe M. González-García, MD Reviewed 10/2018
 


BASICS

DESCRIPTION

Visible or palpable proliferation of unilateral or bilateral breast glandular tissue in a male 

EPIDEMIOLOGY

  • Two age distribution peaks: neonatal, pubertal

  • Neonatal gynecomastia occurs ...

DIAGNOSIS

ALERT
  • Do not mistake pseudogynecomastia (i.e., fatty enlargement of the breasts in obesity) for true gynecomastia.

  • Do not overlook drug-related causes. Drug-related gynecomastia is usually rev...

TREATMENT

MEDICATION

  • Generally, drug therapy should proceed under the guidance of an endocrinologist.

  • Tamoxifen and aromatase inhibitors in off-label use have shown some benefit in benign pubertal gynec...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Reexamine every 3 to 6 months for size and characteristics.

  • Watch for signs of psychological stress.

    • Significant issue in some male adolescents and should not be di...

ADDITIONAL READING

  • Goldman RD. Drug-induced gynecomastia in children and adolescents. Can Fam Physician.  2010;56(4):344–345. [View Abstract on OvidInsights]

  • Lapid O, van Windergen JJ, Perlemuter ...

CODES

ICD9

  • 611.1 Hypertrophy of breast

  • 778.7 Breast engorgement in newborn

ICD10

  • N62 Hypertrophy of breast

  • P83.4 Breast engorgement of newborn

SNOMED

  • 4754008 Gynecomastia (disorder)

  • 34831003 Breast engorgemen...

FAQ

  • Q: When should a neonate with gynecomastia be referred to a specialist?

  • A: For male neonates, if galactorrhea persists at 3 months of age, or the gynecomastia not resolved by 1 year of age.

  • Q: When ...

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