Glass A R
Endocrinology Service, Walter Reed Army Medical Center, Washington, DC.
Endocrinol Metab Clin North Am. 1994 Dec;23(4):825-37.
Gynecomastia is a common finding in men and most often is idiopathic in origin or related to normal puberty. Medications are frequent causes of breast enlargement or tenderness, and hypogonadism of any cause, particularly primary hypogonadism, can lead to gynecomastia. Occasionally, the breast enlargement will reflect an underlying neoplasm that produces steroids or hCG. Underlying systemic disorders (liver disease, renal failure, thyrotoxicosis) can also result in gynecomastia. In most cases, the breast enlargement can be explained by an increased effective estrogen/androgen ratio acting at the breast itself. Therapy should be aimed at correcting any reversible causes, especially when related to medications, and treatment of any serious underlying disorders that are discovered, especially tumors. Medical treatment aimed at reducing the effective estrogen/androgen ratio, particularly with anti-estrogens, appears to be of some effectiveness. Careful surgical removal of excessive tissue can be very helpful, particularly in adolescence and young adulthood.
男性乳房肥大是男性常见的表现，多数情况下病因不明或与正常青春期有关。药物是导致乳房增大或压痛的常见原因，任何原因引起的性腺功能减退，尤其是原发性性腺功能减退，都可导致男性乳房肥大。偶尔，乳房增大可能提示存在产生类固醇或人绒毛膜促性腺激素（hCG）的潜在肿瘤。潜在的全身性疾病（如肝病、肾衰竭、甲状腺毒症）也可导致男性乳房肥大。在大多数情况下，乳房增大可归因于作用于乳房自身的有效雌激素/雄激素比值升高。治疗应旨在纠正任何可逆性病因，尤其是与药物相关的病因，并治疗发现的任何严重潜在疾病，特别是肿瘤。旨在降低有效雌激素/雄激素比值的药物治疗，尤其是使用抗雌激素药物，似乎有一定效果。仔细手术切除过多组织可能非常有帮助，尤其是在青春期和青年期。
