Kaushik Himanshi, Devde Kanchan D, Manuja Nishtha, Arora Rahul, Dongre Amol
Medical Oncology, Jawaharlal Nehru Medical College, Wardha, IND.
Medicine, Jawaharlal Nehru Medical College, Wardha, IND.
Cureus. 2024 Dec 21;16(12):e76121. doi: 10.7759/cureus.76121. eCollection 2024 Dec.
Gynecomastia, the abnormal enlargement of male breast tissue, is a rare side effect associated with dasatinib. This drug is used in the treatment of chronic myeloid leukemia (CML). We present a case of dasatinib-induced gynecomastia in a 52-year-old gentleman with CML who developed bilateral breast enlargement and tenderness after approximately four months of dasatinib treatment. The patient's hormonal profile was within normal limits, including testosterone, estradiol, prolactin, and follicle-stimulating hormone levels. While the exact pathophysiology remains unclear, it is postulated that dasatinib's inhibition of various kinases, including src family kinases and receptor kinases, may contribute to developing gynecomastia. The reported incidence of dasatinib-induced gynecomastia is low, and the onset of symptoms can vary widely. Management strategies for dasatinib-induced gynecomastia are not well-established, but options include androgen support, tamoxifen, or switching to an alternative tyrosine kinase inhibitor. This case report highlights the importance of monitoring patients on dasatinib therapy for developing gynecomastia and other hormonal abnormalities. Clinicians should educate the patients about the possibility of this potential adverse effect, emphasizing the need to report any symptoms indicative of low testosterone syndromes. Further research is warranted to better understand the underlying mechanisms, risk factors, and optimal management strategies for dasatinib-induced gynecomastia.
男性乳房肥大是指男性乳腺组织异常增大,是与达沙替尼相关的一种罕见副作用。这种药物用于治疗慢性髓性白血病(CML)。我们报告一例52岁患有慢性髓性白血病的男性患者,在接受达沙替尼治疗约四个月后出现双侧乳房增大和压痛,诊断为达沙替尼所致男性乳房肥大。患者的激素水平,包括睾酮、雌二醇、催乳素和促卵泡激素水平均在正常范围内。虽然确切的病理生理机制尚不清楚,但据推测,达沙替尼对包括src家族激酶和受体激酶在内的多种激酶的抑制作用可能导致男性乳房肥大的发生。报道的达沙替尼所致男性乳房肥大的发生率较低,症状出现的时间差异很大。达沙替尼所致男性乳房肥大的管理策略尚未明确,但可选择的方案包括雄激素支持、他莫昔芬治疗或换用其他酪氨酸激酶抑制剂。本病例报告强调了在接受达沙替尼治疗的患者中监测男性乳房肥大和其他激素异常情况的重要性。临床医生应告知患者这种潜在不良反应的可能性,强调报告任何低睾酮综合征症状的必要性。有必要进行进一步研究,以更好地了解达沙替尼所致男性乳房肥大的潜在机制、危险因素和最佳管理策略。