gynecomastia slide presentation & music composition by: dr. seyed reza samsamshariat
TRANSCRIPT
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Gynecomastia Slide presentation & music composition by:
Dr. Seyed Reza Samsamshariat
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Gynaecomastia means enlargement of the male breast
http://www.csisite.com/gynecomastia.html
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There is increase of ductal structures and periductal stroma.
If the condition lasts for longer than a year the stroma becomes fibrous.
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Other conditions causing male breast swelling like gynecomastia
Carcinoma Lipoma Neurofibroma
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Neonatal
Puberty
Eldery
Ages in which gynecomastia is common (physiologic gynecomastia)
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Pathophysiology of the gynocomastia
Unknown Decreased ratio of androgen to oesterogen
Hypersensitivity of the breast to hormones
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70% of the male neonates have some breast enlargement.
Because hCG stimulates testis to produce estrogen.
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Pubertal gynecomastia
Gynecomastia
Accompa-nied by prolactin raise
Raise in
oesteradiol
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Treatment of the pubertal gynecomastia
Mild gynecomastia Usually regresses
Moderate to marked degrees
persistsTreated
with tamoxifen
Plastic surgery
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Plastic surgery of the gynecomastia
http://www.google.com/imgres?imgurl=http://www.plasticsurgerypractice.com/content/PSP/2006/03/img/p7fig2.jpg&imgrefurl=http://www.plasticsurgerypractice.com/issues/articles/2006-03_07.asp&usg=__EUMRQejRqMy6SFUewtoFE0ztpHY=&h=203&w=225&sz=14&hl=en&start=18&zoom=1&tbnid=5HrSLIgsxKh70M:&tbnh=142&tbnw=157&ei=yfnLTZbdMpKq8APl4tmhBA&prev=/search%3Fq%3Dgynecomastia%2Bsurgery%26hl%3Den%26biw%3D1272%26bih%3D619%26gbv%3D2%26tbm%3Disch0%2C432&itbs=1&iact=hc&vpx=160&vpy=342&dur=57&hovh=162&hovw=180&tx=118&ty=85&page=2&ndsp=18&ved=1t:429,r:6,s:18&biw=1272&bih=619
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Differential diagnosis of the physiologic pubertal gynecomastia
Side effect of some of the drugs
Testicular tumors
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Senescent gynecomastia
Gynecomastia is associated
with
Hormone imbalance
s
Loss of libido
Flashing
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Differential diagnosis of the physiologic senescent gynecomastia
Liver disease
Drug ingestion
Bronchogenic carcinoma
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Testicular disorders causing gynecomastia
• Klinefelter’s syndrome
Hypogonadism
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5% of the hyperthyroid males have gynecomastia
Hyperthyroidism
Affects liver
Excess conversion of androgen to estrogen
Gynecomastia
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The adrenal diseases which
cause gynecomastia
Adrenocortical
carcinoma
Adenoma
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Findings in adrenocortical carcinoma
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Pituitary tumors with gynecomastia
Acidophil tumors
Chromophobe tumors
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Mechanism by which pituitary tumors cause
gynecomastia •Prolactin secretion•Gonadotropin supression
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Hypothalamic disorde
rs
•May give rise to precocious puberty &•Gynecomastia
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Disorders of sex differentiationMale _pseudohermaphroditismhttp://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=-757385754
Testicular feminization syndromehttp://www.health-writings.com/klinefelter-turner-syndrome/
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Gynecomastia in liver dysfunction
Decline in testosterone production
Increased conversion of androgen to estrogen
Increased sex hormone binding globulin (SHBG)
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Neurological disorders causing
gynecomastia
Traumatic paraplegia
Dystrophia myotonica
Fredreich’s ataxia
Syringomyelia
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Respiratory disorders with gynecomastia
Carcinoma of the bronchus• Produces hCG like hormone Chronic suppurative lung disease
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Renal failure
Neoplasia
Congestive cardiac failure
Tuberculosis
cirrhosis
diabetes
Gynecomastia may occur in chronic debilitating diseases
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Many drugs may cause
gynecomastia ( see the next
slide).
Drugs
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Some of the drugs which’s side effect is gynecomastia
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1-Hart. F Dudley. French’s index of differential dignosis. 12th Edition. wright Bristol. 1985. 315-319.2- Websites mentioned in the slides.
References: