A 13 year old boy has bilateral gynecomastia. His height is 148 cm, weight 58 kg; the sexual maturity rating is stage 2. The gynecomastia is most likely due to -
Ans. is 'c' i.e., Pubeal gynecomastia o It is a case of pubeal gynecomastia. o Both the sexual and physical growth of the boy is normal for his age. o The boy belongs to the early adolescent group and his SMR (sexual maturity rating) is 2 which is normal for his age. Physiological pubeal gynecomastia o Development of gynecomastia in early to mid pubey in some boys o It can be both unilateral and bilateral o The breast may present with transitory tenderness o The breast regresses spontaneously and rarely persists for more than 2 years Mean concentration of all the Sex hormones such as FSH, LH, Prolactin, Testosterone, Estrone and Estradiol are normal. About other options: ? Testicular tumour - The sexual maturity rating of the boy will be altered because of the alteration in the level of the sexual hormone level . Chronic liver disease - Chronic liver disease can also cause gynecomastia, but the patient will present with signs and symptoms of Chronic liver disease along with Gynecomastia. Prolactinoma - Prolactinoma are more common in adolescent females but can also present in adolescent males. Most of the patients will present with loss of libido and signs of visual field defects.
Prolactinoma
Testicular tumour
Pubeal gynecomastia
Chronic liver disease