Etiological Analysis of Gynecomastia in Children

Kim, Jai Keun; Oh, Ki Keun; Yoon, Choon Sik; Park, Jae Hyun

Abstract

PURPOSE
The purpose of this study is to analyze the etiology of gynecomastia confirmed by breast operation among children under the age of 15 exhibiting clinical symptoms.
METHODS
Twenty patients under the age of 15 were diagnosed as having gynecomastia in the past 10 years. The number of pathologically confirmed gynecomastia patients was 15. The causes or related diseases were examined. Various clinical manifestations and radiological findings related to gynecomastia were evaluated.
RESULTS
Of 20 pediatric patients diagnosed as having gynecomastia, 8 cases were pubertal or idiopathic gynecomastia, but 12 cases (60%) had underlying causes. The 12 cases had an etiology, 6 cases were related to abnormal sexual differentiation, 4 cases were drug-induced, and 2 cases were obesity-related. Of the 4 drug-related cases, the past history of long-term medication of anti- tuberculous drug, INH, was present in 3 cases and thiazide in one case. In the group related to abnormal sexual differentiation, pseudohermaphroditism was found in 3 cases and Reifenstein SD, Maffucci SD, and Klinefelter SD was found in each case.
CONCLUSION
Although it is known that most gynecomastia is either idiopathic or puberty-related, we were able to discover etiologic agents such as drugs, obesity, and abnormal sexual differentiation in 60% of the children under 15 of age years old. Therefore, in children with gynecomastia, the presence of any congenital diseases should be searched carefully, and the underlying cause of gynecomastia should be thoroughly searched for.