Meyer Patrick
Service d'endocrinologie, diabétologie et nutrition, HUG, 1211 Genève 14.
Rev Med Suisse. 2009 Apr 8;5(198):783-7.
Gynecomastia is a benign proliferation of the glandular tissue of the male breast and results from an imbalance between androgen and estrogen action. It must be differentiated from lipomastia and breast carcinoma. Gynecomastia is physiologic in infancy, adolescence and in middle-aged to elderly men and is associated with various conditions such as side effects of medications and disorders with low androgens or high estrogens levels. In the absence of a clearly apparent cause, biochemical testing should include evaluation of kidney, liver and thyroid function and measurement of LH, hCG, estradiol and total testosterone. However this evaluation is commonly normal and gynecomastia classified as idiopathic. During the acute stage of gynecomastia, a trial of tamoxifen for up to 3 months may be attempted.
男性乳房肥大是男性乳腺腺体组织的良性增生，由雄激素和雌激素作用失衡引起。它必须与脂肪性乳房肥大和乳腺癌相鉴别。男性乳房肥大在婴儿期、青春期以及中老年男性中是生理性的，并且与多种情况相关，如药物副作用以及雄激素水平低或雌激素水平高的疾病。在没有明显病因的情况下，生化检查应包括评估肾、肝和甲状腺功能以及测量促黄体生成素（LH）、人绒毛膜促性腺激素（hCG）、雌二醇和总睾酮。然而，这种评估通常是正常的，男性乳房肥大被归类为特发性。在男性乳房肥大的急性期，可以尝试使用他莫昔芬进行长达3个月的试验性治疗。
