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Plast Reconstr Surg. 2008 Mar;121(3):34e-40e. doi: 10.1097/01.prs.0000299299.46365.7e.

Neurofibromatosis: a cause of prepubertal gynecomastia.

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  • 1Department of Plastic Surgery, Medical College of Wisconsin, Milwaukee, USA.

Abstract

BACKGROUND:

Atypical presentations of gynecomastia not associated with obesity are often underappreciated. Unilateral manifestation, prepubertal onset, and a history of associated disorders may contribute to a unique clinical presentation for which the diagnosis and management may remain uncertain. This report reviews neurofibromatosis as a cause for atypical presentation of gynecomastia in prepubertal boys to help establish guidelines for diagnosis and management.

METHODS:

Six nonobese male patients (body mass index <or=20) had an onset of gynecomastia at younger than 9 years and were referred for evaluation between June of 1994 and December of 2006.

RESULTS:

The median age of onset of breast enlargement was 7(1/2) years (range, 4 to 8 years). Three had bilateral involvement, four had localized involvement of the nipple-areola complex, and two had diffusely involved breast tissue. Five of the six patients were African American (compared with 20 percent for classic gynecomastia). Median postoperative follow-up was 7 years, and all were followed beyond puberty. No recurrences were seen, although one patient developed a metachronous lesion in the contralateral breast. No patient had an abnormal endocrine metabolic workup.

CONCLUSIONS:

Atypical gynecomastia may present in the prepubertal boy and appears more prevalent in African Americans. For neurofibromatosis, it is more likely unilateral, can be localized to the nipple-areola complex, or entails diffuse breast involvement. An endocrine workup appears to be noncontributory.

PMID:
18317084
[PubMed - indexed for MEDLINE]
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