Kountouri Ismini, Katsarelas Ioannis, Kokkali Eftychia, Giotas Amyntas, Gkogkos Christos, Chatzinas Dimitrios, Nachopoulos Panagiotis, Faseki Afroditi, Panagiotou Alexandra, Polychronidis Athanasios, Chandolias Miltiadis, Gkiatas Nikolaos, Manolakaki Dimitra, Dimasis Periklis
Department of General Surgery, General Hospital of Katerini, 60132 Pieria, Greece.
Department of Radiology, General Hospital of Katerini, 60132 Pieria, Greece.
Diagnostics (Basel). 2024 Sep 17;14(18):2058. doi: 10.3390/diagnostics14182058.
BACKGROUND/OBJECTIVES: Gynecomastia is a common condition characterized by the benign enlargement of male breast tissue, often resulting from hormonal imbalances. A rare variant, unilateral pseudogynecomastia, involves enlargement due to adipose tissue accumulation without glandular proliferation and can be associated with occupational factors.
We report the case of a 45-year-old male mechanic presenting with unilateral enlargement of the left breast. The patient reported daily microtrauma on his left axilla and chest wall. The clinical evaluation and imaging revealed lipomatosis with pronounced fibrous tissue and no glandular tissue involvement. The hormonal assays were within the normal limits. The patient underwent surgical excision of excess adipose tissue using the Kornstein technique, preserving the nipple-areola complex.
The histopathological examination confirmed the absence of malignancy. The postoperative recovery was uneventful, and the follow-up examination at 12 months demonstrated a symmetrical breast appearance with no recurrence. This case underscores the importance of differentiating pseudogynecomastia from true gynecomastia and recognizing potential occupational risks. Surgical management using techniques that preserve the nipple-areola complex can achieve excellent cosmetic outcomes.
背景/目的：男性乳房肥大是一种常见病症，其特征为男性乳腺组织的良性增生，通常由激素失衡引起。一种罕见的变异型，单侧假性男性乳房肥大，是由于脂肪组织堆积而导致的乳房增大，无腺体增生，且可能与职业因素有关。
我们报告了一例45岁男性机械师，其左侧乳房出现单侧增大。患者自述左侧腋窝和胸壁每日受到微创伤。临床评估和影像学检查显示为脂肪瘤病，伴有明显的纤维组织，无腺体组织受累。激素检测结果在正常范围内。患者采用科恩斯坦技术接受了多余脂肪组织的手术切除，保留了乳头乳晕复合体。
组织病理学检查证实无恶性病变。术后恢复顺利，12个月的随访检查显示乳房外观对称，无复发。该病例强调了区分假性男性乳房肥大与真性男性乳房肥大以及认识潜在职业风险的重要性。采用保留乳头乳晕复合体的技术进行手术治疗可取得极佳的美容效果。
