Abstract

HUNG HUANG, Seilee et al. Multifactorial Gynecomastia in the Elderly: Pathophysiological review of a case. Rev. Venez. Endocrinol. Metab. [online]. 2016, vol.14, n.1, pp.45-55. ISSN 1690-3110.

Objective: To describe the pathophysiology in an elderly patient who consulted for bilateral gynecomastia of multifactorial origin. Case report: Male patient, 66 years old, who started current disease for 5 years ago characterized by increased volume in both breasts, predominantly right, accompanied by mastalgia. He presented previous diagnosis of diabetes mellitus type 2 about 10 years ago, poorly controlled, receiving glimepiride 4 mg per day orally. Chronic liver disease of probable alcoholic etiology diagnosed 10 years ago, complicated with esophageal varices treated with propranolol 40 mg orally daily until today; he received spironolactone 100 mg orally daily for about five years, which was omitted due to the appearance of breast volume increase and pain. Upper gastrointestinal bleeding 10 years ago from esophageal varices. Frequent drinking habits until drunkenness since youth, for 10 years.. Physical examination reports weight: 85 kg, height: 164 cm, body mass index: 31.7 kg/m², blood pressure: 137/72 mmHg, heart rate: 57 lpm, in good condition. Asymmetrical breasts with grade 3 bilateral gynecomastia, not galactorrhea; liver measures by palpation 10-09-15 cms, hands with palmar erythema. Conclusion: Gynecomastia in older adults may have pathophysiologically a multifactorial origin, being the decrease in serum testosterone the common denominator. Early treatment can improve symptoms and progression of it.

Keywords : gynecomastia; hypogonadism; testosterone.

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