Gynecomastia on Computed Tomography of The Chest -Prevalence in A Clinical Population and An Analysis of Possible Causes.

Abstract

Gynecomastia is a common appearance in adolescents as well as elderly men. Pathophysiologically it is caused by an imbalance between testosterone and estrogen. During puberty the cause is an elevated estrogen secretion and in the elderly the cause is a relative increase in estrogen activity due to the reduced levels of secreted testosterone. Gynecomastia can also be caused by hormonal secreting tumors, endocrinological disorders, liver cirrhosis, obesity, medication or drug abuse (1). Gynecomastia has been reported to be a common incidental finding on computed tomography (CT) of the chest, but the prevalence of this finding has not been reported before (2). Therefore, the prevalence of gynecomastia on CT of the chest was studied in this retrospective study. All chest CT scans performed at our department during February 2017 were retrospectively reviewed. The sample consisted of 82 male patients with a mean age of 67 years (range 21-89 years). All patients were examined with a 16-slice CT scanner (Activion®, Toshiba Medical Systems, Tokyo, Japan). The reconstructed 5 mm axial slices were reviewed in a standard soft tissue window setting using the departmental PACS (SynedraView®, Synedra Information Technology, Innsbruck, Austria). Gynecomastia was defined as subareolar tissue measuring more than 2 cm on the axial slices. Because a small amount of breast tissue is considered a normal finding, a cutoff of 2 cm was used according to definitions in the radiological literature (2). In patients with gynecomastia a chart review for possible underlying causes was performed.