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An endocrinological study of persistent pubertal macromastia
S Aritaki1, H Miyazawa, M Ogihara
1Department of Pediatrics, Tokyo Medical College.
The Tohoku Journal of Experimental Medicine
|July 1, 1992
Summary
Persistent pubertal macromastia in males is linked to abnormal hormone levels, specifically low testosterone to estrogen ratios. Current drug therapies show unsatisfactory results for this condition.
Area of Science:
- Endocrinology
- Pediatric Endocrinology
- Reproductive Endocrinology
Background:
- Persistent pubertal macromastia is a severe form of pubertal gynecomastia.
- It affects a subset of pubertal males, differing from transient physiological gynecomastia.
- Characterized by significant breast enlargement and distinct endocrinological abnormalities.
Observation:
- Endocrinological evaluation of three males with persistent pubertal macromastia revealed elevated or high-normal testosterone (T) levels.
- Patients exhibited high estrone (E1) and estradiol (E2) levels, resulting in decreased T/E1 and T/E2 ratios.
Findings:
- The persistence of low testosterone-to-estrogen ratios (T/E1 and T/E2) is hypothesized as the cause of macromastia.
- Therapeutic interventions using cyproterone acetate, tamoxifen citrate, danazol, and clomiphene citrate yielded unsatisfactory outcomes.
Implications:
- Persistent pubertal macromastia represents a pathological extreme of physiological pubertal gynecomastia.
- Its distinct clinical course and treatment needs necessitate further research beyond typical gynecomastia management.
- Abnormal endocrinological findings highlight the need for targeted diagnostic and therapeutic strategies.