Montiel-Jarquín Alvaro, Reyes-Páramo Pedro, Ramos-Alvarez Gloria, López-Colombo Aurelio, Tinajero-Esquivel Magdalena, Ruiz-León Betzabé
Departamento de Cirugía General, Unidad Médica de Alta Especialidad Puebla, Instituto Mexicano del Seguro Social, Polimédica Sur, Av. Cue Merlo 802-E, 73550 San Baltazar Campeche, Puebla, Puebla, México.
Cir Cir. 2007 Sep-Oct;75(5):327-31.
Gynecomastia describes a benign increase of the mammary gland in men. When medical treatment fails, symptoms and psychological alterations persist. Subdermal mastectomy is the definitive treatment and can be achieved by different incisions, each with potential complications. We undertook this study to present clinical characteristics of 11 patients with gynecomastia and the results obtained with subdermal mastectomy by means of external periareolar incision.
A descriptive cohort study in male patients with gynecomastia was carried out in a third-level medical care hospital. Patients were treated with subdermal mastectomy by means of external periareolar incision.
There were 11 male patients with an average age of 19 years (range: 11-60 years), 3 patients (27.2%) with bilateral gynecomastia and 8 patients (72.7%) with unilateral gynecomastia. Average time of evolution was 22 months (range: 16-48 months), 9 patients (81.8%) reported pain, 11 patients (100%) reported psychological alterations with cutaneous alteration, 11 patients (100%) had normal secondary sexual characteristics, 1 patient (9%) had supernumerary nipple development, and 11 patients (100%) had well-defined lesions. According to Simon's classification: seven patients (63.6%) were classified as grade 1, three patients (27.2%) as grade 2 and one patient (9.09%) as grade 3. Each patient had a subdermal mastectomy with external periareolar incision, 11 patients (100%) had a histopathological report of gynecomastia; 1 patient (9.09%) displayed keloid healing and none displayed complications inherent to the surgical procedure.
Mastectomy by means of external periareolar incision is useful in the treatment of gynecomastia.
男性乳房肥大是指男性乳腺的良性增生。当药物治疗无效时，症状和心理改变会持续存在。皮下乳房切除术是最终的治疗方法，可通过不同的切口实现，每种切口都有潜在的并发症。我们进行这项研究以呈现11例男性乳房肥大患者的临床特征，以及经乳晕外周切口皮下乳房切除术的结果。
在一家三级医疗机构对男性乳房肥大患者进行描述性队列研究。患者接受经乳晕外周切口皮下乳房切除术。
11例男性患者，平均年龄19岁（范围：11 - 60岁），3例（27.2%）为双侧乳房肥大，8例（72.7%）为单侧乳房肥大。平均病程为22个月（范围：16 - 48个月），9例（81.8%）报告有疼痛，11例（100%）报告有心理改变伴皮肤改变，11例（100%）第二性征正常，1例（9%）有额外乳头发育，11例（100%）病变界限清晰。根据西蒙分类法：7例（63.6%）为1级，3例（27.2%）为2级，1例（9.09%）为3级。每位患者均接受经乳晕外周切口皮下乳房切除术，11例（100%）有乳房肥大的组织病理学报告；1例（9.09%）出现瘢痕疙瘩愈合，无手术相关并发症。
经乳晕外周切口乳房切除术对男性乳房肥大的治疗有效。
