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Findings of Gynecomastia That Developed in Follow-up Secondary to Bicalutamide Treatment on Bone Scan
1Acıbadem University, Department of Nuclear Medicine, İstanbul, Turkey.
Abstract:
Prostate cancer is a common neoplastic disease especially in elder patients. Metastatic prostate disease has low five-year survival rate. Bicalutamide is an androgen receptor antagonist that acts as an inhibitor by competizing androgen receptors in the target tissue and used as a treatment option in prostate cancer. Bone scan was performed on a 79-year-old male with prostate cancer in our department. Blood pool images showed bilateral hyperemia in the breast regions which was not present on the previous scan one year ago. On physical examination, there was bilateral painful gynecomastia. It was learned that the patient was given Bicalutamide therapy after the first bone scan. Blood pool images may detect this side effect and should be evaluated with physical examination in case of clinical doubt.
Insights
Bicalutamide, a prostate cancer drug, can cause painful gynecomastia (breast enlargement) as a side effect. Bone scans may reveal this condition, necessitating physical examination for accurate diagnosis.
Area of Science:
- Oncology
- Endocrinology
Background:
- Prostate cancer is a prevalent neoplastic disease, particularly in elderly males.
- Metastatic prostate cancer is associated with a poor five-year survival rate.
- Bicalutamide is an androgen receptor antagonist used in prostate cancer treatment.
Purpose of the Study:
- To report a case of bilateral painful gynecomastia in a patient undergoing prostate cancer treatment.
- To highlight the potential of bone scan blood pool imaging in detecting Bicalutamide-induced gynecomastia.
- To emphasize the importance of correlating imaging findings with physical examination.
Main Methods:
- A 79-year-old male with prostate cancer underwent a bone scan.
- Blood pool images from the bone scan were analyzed for changes in breast vascularity.
- Physical examination was performed to assess for gynecomastia.
Main Results:
- Bone scan blood pool images revealed bilateral hyperemia in the breast regions, a new finding compared to a previous scan.
- Physical examination confirmed bilateral painful gynecomastia.
- The patient was receiving Bicalutamide therapy for prostate cancer.
Conclusions:
- Bilateral hyperemia on bone scan blood pool images may indicate Bicalutamide-induced gynecomastia.
- Clinical evaluation, including physical examination, is crucial when imaging suggests gynecomastia.
- Early detection of this side effect can aid in patient management.
