J Korean Med Sci.  2005 Jun;20(3):512-515. 10.3346/jkms.2005.20.3.512.

Concurrent Male Gynecomastia and Testicular Hydrocele after Imatinib Mesylate Treatment of a Gastrointestinal Stromal Tumor

• Kim H
• Chang HM
• Ryu MH
• Kim TW
• Sohn HJ
• Kim SE
• Kang HJ
• Park S
• Lee JS
• Kang YK

• KMID: 1778518
• DOI: http://doi.org/10.3346/jkms.2005.20.3.512

Abstract

We report a gastrointestinal stromal tumor (GIST) patient with male gynecomastia and testicular hydrocele after treatment with imatinib mesylate. A 42 yr-old male patient presented for management of hepatic masses. Two years earlier, he had undergone a small bowel resection to remove an intraabdominal mass later shown to be a GIST, followed by adjuvant radiation therapy. At presentation, CT scan revealed multiple hepatic masses, which were compatible with metastatic GIST, and he was prescribed imatinib 400 mg/day. During treatment, he experienced painful enlargement of the left breast and scrotal swelling. Three months after cessation of imatinib treatment, the tumors recurred, and, upon recommencing imatinib, he experienced painful enlargement of the right breast and scrotal swelling. He was diagnosed with male gynecomastia caused by decreased testosterone and noncommunicative testicular hydrocele. He was given androgen support and a hydrocelectomy, which improved his gynecomastia. The mechanism by which imatinib induces gynecomastia and hydrocele is thought to be associated with an inhibition of c-KIT and platelet-derive growth factor. This is the first report, to our knowledge, describing concurrent male gynecomastia and testicular hydrocele after imatinib treatment of a patient with GIST.

Keyword

Gynecomastia; Hydrocele; imatinib; Gastrointestinal Stromal Tumors

MeSH Terms

Adult
Androgens/therapeutic use
Antineoplastic Agents/adverse effects/therapeutic use
Gastrointestinal Stromal Tumors/*drug therapy
Gynecomastia/*chemically induced/complications/drug therapy
Humans
Hydrocele/*chemically induced/complications/drug therapy
Male
Piperazines/*adverse effects/therapeutic use
Pyrimidines/*adverse effects/therapeutic use
Testis/drug effects/pathology/ultrasonography

Figure

• 

  Fig. 1 Ultrasonographic finding of testicular hydrocele. There is a large amount of fluid in the right scrotal sac, and the right testis is displaced downwardly. There was no evidence, however, of any other mass.

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