Gynecomastia: A Review and an Analysis of 160 Cases

Article1 May 1954GYNECOMASTIA: A REVIEW AND AN ANALYSIS OF 160 CASESCLAYTON E. WHEELER, EDWARD P. CAWLEY, F.A.C.P., HENRY T. GRAY, ARTHUR C. CURTIS, F.A.C.P.CLAYTON E. WHEELERSearch for more papers by this author, EDWARD P. CAWLEY, F.A.C.P.Search for more papers by this author, HENRY T. GRAYSearch for more papers by this author, ARTHUR C. CURTIS, F.A.C.P.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-40-5-985 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptGynecomastia has been reported as an accompaniment of certain physiologic states and a wide variety of pathologic conditions. It is the purpose of this paper to (1) define gynecomastia, (2) review the theories concerning its etiology, (3) report the data derived from an analysis of 160 cases of gynecomastia, (4) discuss etiologic possibilities suggested by a study of the 160 cases, (5) point out some of the clinical implications of gynecomastia, and (6) suggest a clinical classification of conditions which may be accompanied by gynecomastia.DEFINITION OF GYNECOMASTIAGynecomastia (derived from two Greek words meaningwomanandbreast) implies a...Bibliography1. AlbrightScovilleSulkowitch FBHW: Syndrome characterized by osteitis fibrosa disseminata, areas of pigmentation and gonadal dysfunction, Endocrinology 22: 411 (Apr.) 1938. CrossrefGoogle Scholar2. Albright F: Polyostotic fibrous dysplasia: a defense of the entity, J. Clin. Endocrinol. 7: 307 (May) 1947. CrossrefGoogle Scholar3. AstwoodGeschickterRausch EBGFEO: Development of the mammary gland of the rat, Am. J. Anat. 61: 373 (Sept.) 1937. CrossrefGoogle Scholar4. BauerGoodwin FKWE: Acne and gynecomastia following I131 therapy for hyperthyroidism, J. Clin. Endocrinol. 11: 1574 (Dec.) 1951. CrossrefGoogle Scholar5. Bernstein MH: Gynecomastia associated with primary liver cell carcinoma, South. M. J. 41: 1111 (Dec.) 1948. CrossrefMedlineGoogle Scholar6. BiskindBiskind GRMS: The nutritional aspects of certain endocrine disturbances, Am. J. Clin. Path. 16: 737 (Dec.) 1946. CrossrefMedlineGoogle Scholar7. Bruner JA: Distribution of chorionic gonadotropin in mother and fetus at various stages of pregnancy, J. Clin. Endocrinol. 11: 360 (Apr.) 1951. CrossrefGoogle Scholar8. Del CastilloTrabuccode la Balze EBAFA: Syndrome produced by absence of the germinal epithelium without impairment of the Sertoli or Leydig cells, J. Clin. Endocrinol. 7: 493 (July) 1947. CrossrefGoogle Scholar9. CooperRynearsonBaileyMacCarty ISEHAACS: The relation of spinal cord diseases to gynecomastia and testicular atrophy, Proc. Staff. Meet., Mayo Clin. 25: 320 (June) 1950. MedlineGoogle Scholar10. CooperMacCartyRynearson ISCSEH: Gynecomastia in paraplegic males, J. Neurosurg. 7: 364 (July) 1950. CrossrefMedlineGoogle Scholar11. CowieFolley ATSJ: The role of the adrenal cortex in mammary development and its relation to the mammogenic action of the anterior pituitary, Endocrinology 40: 274 (Apr.) 1947. CrossrefMedlineGoogle Scholar12. Davidoff LM: Studies in acromegaly. III. The anamnesis and symptomatology in one hundred cases, Endocrinology 10: 461 (Sept.-Oct.) 1926. CrossrefGoogle Scholar13. EdwardsShimkenShaver RAMBJS: Hypertrophy of the breast due to injection of adrenal cortex extract in a man with Addison's disease, J. A. M. A. 111: 412 (July 30) 1938. CrossrefGoogle Scholar14. EvansYoungHertzTullnerWilmerWood JMJPRWWGD: The ability of the human liver to reduce biologic activity of injected estrogens, J. Clin. Endocrinol. 12: 495 (May) 1952. CrossrefGoogle Scholar15. Gilbert JB: Studies in malignant testis tumors: 2. Syndrome of choriogenic gynecomastia, J. Urol. 44: 345 (Sept.) 1940. CrossrefGoogle Scholar16. GlassEdmondsonSoll SJHASN: Sex hormone changes associated with liver disease, Endocrinology 27: 749 (Nov.) 1940. CrossrefGoogle Scholar17. GoldzieherRoberts JWIS: Identification of estrogen in human testis, J. Clin. Endocrinol. 12: 143 (Feb.) 1952. CrossrefGoogle Scholar18. GomezTurner ETCW: Further evidence for a mammogenic hormone in the anterior pituitary, Proc. Soc. Exper. Biol. and Med. 37: 607 (Jan.) 1938. CrossrefGoogle Scholar19. GrabstaldSwan HLL: Genitourinary lesions in leprosy, J. A. M. A. 149: 1287 (Aug. 2) 1952. CrossrefGoogle Scholar20. Greene R: Abnormalities of the breast in men, Practitioner 165: 512 (Nov.) 1950. MedlineGoogle Scholar21. GreepStavely ROHE: "Mammogen" and the treatment of spayed rats with lipoid extracts of cattle pituitary, Endocrinology 29: 18 (July) 1941. CrossrefGoogle Scholar22. HellerNelson CGWO: Hyalinization of seminiferous tubules associated with normal or failing Leydig-cell function; discussion of relationship to eunuchoidism, gynecomastia, elevated gonadotrophins, depressed 17-ketosteroids and estrogens, J. Clin. Endocrinol. 5: 1 (Jan.) 1945. CrossrefGoogle Scholar23. HetzelHinesStenhouse BSDCNS: Adrenal cortical function in hypertension, J. Clin. Endocrinol. 12: 296 (Mar.) 1952. CrossrefGoogle Scholar24. Hibbs RE: Gynecomastia associated with vitamin deficiency diseases, Am. J. M. Sc. 213: 176 (Feb.) 1947. CrossrefMedlineGoogle Scholar25. HurxthalMusulin LMN: Gynecomastia. A case associated with mixed tumor of renal origin and testicular atrophy, Lahey Clin. Bull. 4: 38 (Oct.) 1944. Google Scholar26. Jacobs EC: Gynecomastia following severe starvation, Ann. Int. Med. 28: 792 (Apr.) 1948. LinkGoogle Scholar27. JungShafton FTAL: Mastitis, mazoplasia, mastalgia and gynecomastia in normal adolescent males, Illinois M. J. 73: 115 (Feb.) 1938. Google Scholar28. KarkMoreyPaynter RMGRCR: Re-feeding (nutritional) gynecomastia in cirrhosis of the liver: I. Clinical observations, Am. J. M. Sc. 222: 154 (Aug.) 1951. CrossrefMedlineGoogle Scholar29. Karsner HT: Gynecomastia, Am. J. Path. 22: 235 (Mar.) 1946. Google Scholar30. KlatskinSalterHumm GWTFD: Gynecomastia due to starvation. 1. Clinical studies, Am. J. M. Sc. 213: 19 (Jan.) 1947. CrossrefMedlineGoogle Scholar31. KlatskinRappaport GEM: Gynecomastia due to infectious hepatitis of the homologous serum type, Am. J. M. Sc. 214: 121 (Aug.) 1947. CrossrefMedlineGoogle Scholar32. KlatskinMunson GPL: Experimental production of gynecomastia, Yale J. Biol. and Med. 24: 474 (June) 1952. MedlineGoogle Scholar33. KlinefelterReifensteinAlbright HFECF: Syndrome characterized by gynecomastia, aspermatogenesis without a-Leydigism and increased excretion of follicle stimulating hormone, J. Clin. Endocrinol. 2: 615 (Nov.) 1942. CrossrefGoogle Scholar34. Kyle LH: Gynecomastia in association with ulcerative colitis, New England J. Med. 240: 537 (Apr.) 1949. CrossrefMedlineGoogle Scholar35. De la BalzeArrillagaIrazuMancini FAFCJRE: Klinefelter's syndrome—a study of 5 cases, J. Clin. Endocrinol. 12: 1426 (Nov.) 1952. CrossrefGoogle Scholar36. LeonardReece SLRP: Failure of steroid hormones to induce mammary growth in hypophysectomized rats, Endocrinology 30: 32 (Jan.) 1942. CrossrefGoogle Scholar37. Le Winn EB: Gynecomastia during digitalis therapy, New England J. Med. 248: 316 (Feb.) 1953. CrossrefMedlineGoogle Scholar38. LewisGeschichter DCF: Gynecomastia, virginal hypertrophy and fibroadenomas of the breast, Ann. Surg. 100: 779 (Oct.) 1934. CrossrefMedlineGoogle Scholar39. LloydWilliams CWRH: Endocrine changes associated with Laennec's cirrhosis of the liver, Am. J. Med. 4: 315 (Mar.) 1948. CrossrefMedlineGoogle Scholar40. Lyons WR: The hormonal basis for "witches milk," Proc. Soc. Exper. Biol. and Med. 37: 207 (Oct.) 1937. CrossrefGoogle Scholar41. MacBryde CM: The production of breast growth in the human female, J. A. M. A. 112: 1045 (Mar. 18) 1939. CrossrefGoogle Scholar42. MaddockNelson WOWO: The effects of chorionic gonadotropin in adult men: increased estrogen and 17-ketosteroid excretion, gynecomastia, Leydig cell stimulation and seminiferous tubule damage, J. Clin. Endocrinol. 12: 985 (Aug.) 1952. CrossrefGoogle Scholar43. Mann LT: Enlargement of the breasts after prostatectomy, Am. J. Surg. 4: 549 (May) 1928. CrossrefGoogle Scholar44. McCullaghRossmiller EPHR: Methyl testosterone. 1. Androgenic effects and the production of gynecomastia and oligospermia, J. Clin. Endocrinol. 1: 496 (June) 1941. CrossrefGoogle Scholar45. McEuenSelyeCollip CSHJB: Effect of the testis on the mammary gland, Proc. Soc. Exper. Biol. and Med. 35: 56 (Oct.) 1936. CrossrefGoogle Scholar46. Menville JG: Gynecomastia, Arch. Surg. 26: 1054 (June) 1933. CrossrefGoogle Scholar47. Merrill JP: The role of the adrenal in hypertension, Ann. Int. Med. 37: 966 (Nov.) 1952. LinkGoogle Scholar48. MidgeonGardner CJLI: Urinary estrogens (measured fluorometrically and biologically) in hyperadrenocorticism: influence of cortisone, compound F, compound B and ACTH, J. Clin. Endocrinol. 12: 1513 (Dec.) 1952. CrossrefGoogle Scholar49. Moehlig RC: Pituitary tumor associated with gynecomastia, Endocrinology 13: 529 (Nov.-Dec.) 1929. CrossrefGoogle Scholar50. MoehligSchreiber RCF: Polyostotic fibrous dysplasia: report of a case with unilateral involvement, Am. J. Roentgenol. 44: 17 (July) 1940. Google Scholar51. Morrione TG: Effect of estrogens on the testis in hepatic insufficiency, Arch. Path. 37: 39 (Jan.) 1944. Google Scholar52. NelsonGauntSchweizer WORM: Effects of adrenal cortical compounds on lactation, Endocrinology 33: 325 (Nov.) 1943. CrossrefGoogle Scholar53. Nelson WE: Witches milk, in Mitchell-Nelson Textbook of pediatrics, 5th Ed., 1950, W. B. Saunders Co., Philadelphia, pp. 36, 307, 315. Google Scholar54. Östergaard E: Feminizing tumor of the testis; presumably aberrant adrenocortical tumor, J. Clin. Endocrinol. 7: 439 (June) 1947. CrossrefGoogle Scholar55. PeinerWaldman LS: Gynecomastia in "liver dysfunction" diabetes, New York State J. Med. 50: 1377 (June) 1950. MedlineGoogle Scholar56. RaleighPhilipsborn GWHF: Addison's disease with partial absence of adrenal cortex and gynecomastia, Arch. Path. 37: 213 (Mar.) 1944. Google Scholar57. ReeceTurner RPCW: Mammary gland development in hypophysectomized albino rat, Proc. Soc. Exper. Biol. and Med. 34: 204 (Mar.) 1936. CrossrefGoogle Scholar58. ReeceMixner RPJP: Effect of testosterone on pituitary and mammary gland, Proc. Soc. Exper. Biol. and Med. 40: 66 (Jan.) 1939. CrossrefGoogle Scholar59. RoseDohanZintelEiman EFCHFJW: Estrogen-producing tumors of the adrenal: report of four cases, J. Clin. Endocrinol. 11: 798 (July) 1951. Google Scholar60. RuppCantarowRakoffPaschkis JAAEKE: Hormone excretion in liver disease and in gynecomastia, J. Clin. Endocrinol. 11: 688 (July) 1951. CrossrefMedlineGoogle Scholar61. SalterKlatskinHumm WTGFD: Gynecomastia due to malnutrition. II. Endocrine studies, Am. J. M. Sc. 213: 31 (Jan.) 1947. CrossrefMedlineGoogle Scholar62. SegaloffSegaloff AA: The role of the vitamines of the B-complex in estrogen metabolism, Endocrinology 34: 346 (May) 1944. CrossrefGoogle Scholar63. ShipleyGyörgy RAP: Effect of dietary hepatic injury on inactivation of estrone, Proc. Soc. Exper. Biol. and Med. 57: 52 (Oct.) 1944. CrossrefGoogle Scholar64. SimpsonJoll SLCA: Feminization in a male adult with carcinoma of the adrenal cortex, Endocrinology 22: 595 (May) 1938. CrossrefGoogle Scholar65. SpankusGrant WHRS: Gynecomastia, J. Clin. Endocrinol. 7: 586 (Aug.) 1947. CrossrefGoogle Scholar66. StaffieriCamesCid JJOJM: Corticoadrenal tumor with hypoglycemic syndrome, goiter, gynecomastia and hepatosplenomegaly, J. Clin. Endrocrinol. 9: 255 (Mar.) 1949. CrossrefGoogle Scholar67. Starr P: Gynecomastia during hyperthyroidism, J. A. M. A. 104: 1988 (June 1) 1935. CrossrefGoogle Scholar68. TrentinTurner JJCW: Quantitative study of the effect of inanition on responsiveness of the mammary gland to estrogen, Endocrinology 29: 984 (Dec.) 1941. CrossrefGoogle Scholar69. TrentinTurner JJCW: Effect of adrenalectomy on the mammary gland of the castrated and estrogen treated castrated male rat, Endocrinology 41: 127 (Aug.) 1947. CrossrefMedlineGoogle Scholar70. UnnaSingherKenslerTaylorRhoads KHOCJHCCP: Effect of dietary protein on liver riboflavin levels and on inactivation of estradiol by liver, Proc. Soc. Exper. Biol. and Med. 55: 254 (Apr.) 1944. CrossrefGoogle Scholar71. Van HeuverswynFolleyGardner JSJWU: Mammary growth in male mice receiving androgens, estrogens and desoxycorticosterone acetate, Proc. Soc. Exper. Biol. and Med. 41: 389 (June) 1939. CrossrefGoogle Scholar72. WarrenOlshausen SKW: Interstitial cell growths of the testicle, Am. J. Path. 19: 307 (Mar.) 1943. MedlineGoogle Scholar73. Weber FP: Gynecomastia and endocrine tumors of the pituitary gland, rare diseases and debatable subjects, 1946, Staples Press, Limited, London, p. 94. Google Scholar74. WheelerCawleyCurtis CEEPAC: The effects of topically applied hormones on growth, pigmentation and keratinization of the nipple and areola, J. Invest. Dermat. 20: 385 (May) 1953. CrossrefMedlineGoogle Scholar75. Wilkins L: A feminizing adrenal tumor causing gynecomastia in a boy of five years contrasted with a virilizing tumor in a five year old girl, J. Clin. Endocrinol. 8: 111 (Jan.) 1948. CrossrefGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: *Received for publication August 1, 1953.From the Department of Dermatology, University of Virginia School of Medicine; and from the Department of Dermatology, University of Michigan Medical School. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited ByBreastImpact of uremia on female reproductive cyclicity, ovulation, and luteinizing hormone in the rat"Diabetic Mastopathy" in the Male BreastA Special Type of Gynecomastia A Comparative Study of Lymphocytic Mastitis and Gynecomastia*Acquired cystic kidney disease: The hormonal hypothesisEvaluation of fine needle aspiration of the male breast for the diagnosis of gynaecomastiaBreast Disorders in Children and AdolescentsCarcinoma in situ of the male breast.Spironolactone Induced GynecomastiaManagement of breast lesions in children and adolescentsClinical Uses of AntiandrogensTestisEndokrinologie in der KinderheilkundeGynecomastia: An Endocrinologic Complication of HemodialysisRICHARD M. FREEMAN, M.D., RICHARD L. LAWTON, M.D., MARGERY O. FEARING, R.N.Transient Gynecomastia in Chronic Renal Failure During Chronic Intermittent HemodialysisGUNTHER W. SCHMITT, M.D., ISAM SHEHADEH, M.D., CLARK T. SAWIN, M.D.Die therapeutische Anwendung der Gestagene beim MenschenGYNÆCOMASTIA ASSOCIATED WITH CARCINOMA OF THE BRONCHUSFamilial GynecomastiaSTANLEY ROSEWATER, B.A., GRANT GWINUP, M.D., GEORGE J. HAMWI, M.D., F.A.C.P.The genetics of sex determination in manFehlbildungen der Haut und Hautveränderungen bei FehlbildungssyndromenGynecomastiaUNEXPECTED GYNÆCOMASTIAPulmonary Artery Aneurysms with Recurrent Thrombophlebitis The "Hughes-Stovin Syndrome"WILLIAM L. KOPP, M.D., ROBERT A. GREEN, M.D.Management of gynecomastiaGYNÆCOMASTIA AND MULTIPLE MYELOMAHereditary GynaecomastiaGynecomastia. The origins of mammary swelling in the male: An analysis of 406 patients with breast hypertrophy, 525 with testicular tumors, and 13 with adrenal neoplasmsRecent Contributions to Adolescent MedicineGynecomastiaA Review of 218 CasesWachstum und EntwicklungTestis 1 May 1954Volume 40, Issue 5Page: 985-1004KeywordsDermatologyEtiologyResearch design Issue Published: 1 May 1954 PDF DownloadLoading ...