Evaluation of breast enlargement in young males and factors associated with gynecomastia and pseudogynecomastia
. Ir J Med Sci 2010; 179: 575-583 (PMID: 19495841) [CrossRef]
Weight gain: this can lead to pseudogynecomastia
Liver disease: one of the tell-tale signs of liver disease is male breast enlargement.
It has to be distinguished from pseudogynecomastia
, the sole accumulation of fat without any glandular proliferation .
Finally, an overlapping meaning can be noted for pseudogynecomastia
, also called lipomastia or augmented adipose tissue (1, 7, 17, 18), as well as for pediatric macromastia, which is also known as juvenile hypertrophy (23).
Your physician should rule out breast cancer as well as other causes of breast swelling, such as fatty tissue (pseudogynecomastia
Obesity can cause a pseudogynecomastia
as well as a true gynecomastia because aromatase enzyme increases with the increase in fat tissue, which converts testosterone to estradiol.
In cases of male breast enlargement, first determine whether you are dealing with true gynecomastia or "pseudogynecomastia," which involves increased fat deposits typically seen in obese individuals.
When obesity is the cause of gynecomastia, the breast examination reveals firm, rubbery tissue (unlike the findings in pseudogynecomastia, where there is a soft enlargement of the breast).
Differentiation of gynecomastia most often involves comparing the condition to certain forms of breast carcinoma and pseudogynecomastia. The latter is a benign enlargement of breasts due to fat deposition rather than glandular proliferation.
Pseudogynecomastia is differentiated from gynecomastia by the preponderance of radiolucent fat and absence of the dense subareolar tissue characteristic of gynecomastia.
Currently, the recommended protocol for palpable mass in male patients is to perform x-ray MG (to distinguish gynecomastia from pseudogynecomastia and to identify suspicious lesions) followed by high-frequency breast US (8).
Subareolar densities, which are not apparent in pseudogynecomastia, are also easily recognized in gynecomastia.