Ho H K, Loh K C
Department of General Medicine, Tan Tock Seng Hospital, Singapore.
Ann Acad Med Singap. 1998 Jul;27(4):594-6.
Although gynaecomastia is a well-documented manifestation among male patients with hyperthyroidism, it is extremely rare to present as the initial or chief complaint in a subject with undiagnosed hyperthyroidism. We report a case of a 38-year-old Chinese man presenting with painful enlargement of both breasts of one month's duration. Examination revealed bilateral tender gynaecomastia. In addition, he was noted to have warm and moist peripheries, resting tachycardia and an enlarged goitre. Hyperthyroidism was confirmed biochemically. Treatment of thyrotoxicosis resulted in resolution of the gynaecomastia. This case report demonstrates that gynaecomastia may predominate over the commonly recognised, more manifest and urgent symptoms of hyperthyroidism.
虽然男性甲状腺功能亢进患者出现乳腺增生是有充分文献记载的表现，但在未确诊的甲状腺功能亢进患者中，以乳腺增生作为首发或主要症状极为罕见。我们报告一例38岁中国男性患者，其双侧乳房疼痛性肿大持续1个月。检查发现双侧触痛性乳腺增生。此外，还注意到他外周温暖湿润、静息时心动过速以及甲状腺肿大。生化检查确诊为甲状腺功能亢进。甲状腺毒症的治疗使乳腺增生消退。本病例报告表明，乳腺增生可能比甲状腺功能亢进常见的、更明显且紧急的症状更为突出。
