Gynaecomastia

Differential diagnosis

• Testicular Ca – testicular lumps, weight loss
• Anabolic steroids
• Liver disease
• Idiopathic

Data gathering

• Red flags – testicular lumps
• Others – steroids
• Examine – pulse, BP, BMI, chest, testicles

Clinical management

• Investigations
  • Bloods – U+E, LFTs, TFTs, hormones (oestrogen, testosterone, prolactin)
  • USS breast, USS testes, CXR

• Explanation
  • common in puberty and older men, need to make sure there are no medical causes e.g. testicle lumps, liver disease, medications

• Treatment
  • Weight loss, clothes

• Follow-up / Safety – net
  • Referral – tamoxifen, cosmetic surgery (not on NHS)