Prepubertal Idiopathic Unilateral Gynecomastia: Case Report and Literature Review

Area of Science:

• Pediatric Endocrinology
• Pediatric Surgery
• Human Genetics

Background:

• Gynecomastia, a benign enlargement of male breast glandular tissue, is typically physiological based on age.
• Prepubertal unilateral gynecomastia is an exceptionally rare clinical presentation.
• Most prepubertal cases of gynecomastia remain idiopathic, lacking a clear underlying cause.

Observation:

• This report details the clinical course and management of a 9-year-old boy with prepubertal idiopathic unilateral gynecomastia.
• A literature review identified 14 additional cases of prepubertal unilateral gynecomastia between 2011 and 2021.
• The rarity is highlighted in contrast to more common pubertal gynecomastia.

Findings:

• Comprehensive diagnostic workup is recommended, including chromosomal, genetic, oncological, endocrine, liver, and kidney function tests.
• Idiopathic prepubertal gynecomastia, particularly the unilateral form, presents a significant challenge due to its rarity.
• Surgical management is a crucial therapeutic option for patients experiencing distress from this rare phenotype.

Implications:

• This case underscores the importance of thorough investigation for rare pediatric endocrine conditions.
• Understanding the idiopathic nature of prepubertal unilateral gynecomastia informs diagnostic and management strategies.
• Addressing the psychological impact of rare physical conditions is vital in pediatric care.