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Review Article| Volume 102, ISSUE 6, P989-1005, December 2022

Management of Gynecomastia and Male Benign Diseases

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      References

        • Braunstein G.D.
        Clinical practice. Gynecomastia.
        N Engl J Med. 2007; 357: 1229-1237
        • Johnson R.E.
        • Murad M.H.
        Gynecomastia: pathophysiology, evaluation, and management.
        Mayo Clin Proc. 2009; 84: 1010-1015
        • Mathur R.
        • Braunstein G.D.
        Gynecomastia: pathomechanisms and treatment strategies.
        Horm Res. 1997; 48: 95-102
        • Kanakis G.A.
        • Nordkap L.
        • Bang A.K.
        • et al.
        EAA clinical practice guidelines-gynecomastia evaluation and management.
        Andrology. 2019; 7: 778-793
        • Nydick M.
        • Bustos J.
        • Dale Jr., J.H.
        • et al.
        Gynecomastia in adolescent boys.
        JAMA. 1961; 178: 449-454
        • Moore D.C.
        • Schlaepfer L.V.
        • Paunier L.
        • et al.
        Hormonal changes during puberty: V. Transient pubertal gynecomastia: abnormal androgen-estrogen ratios.
        J Clin Endocrinol Metab. 1984; 58: 492-499
        • Biro F.M.
        • Lucky A.W.
        • Huster G.A.
        • et al.
        Hormonal studies and physical maturation in adolescent gynecomastia.
        J Pediatr. 1990; 116: 450-455https://doi.org/10.1016/s0022-3476(05)82843-4
        • Braunstein G.D.
        What Accounts for the Increased Incidence of Gynecomastia Diagnosis in Denmark from 1998–2017?.
        J Clin Endocrinol Metab. 2020; 105: e3810-e3811
        • Mieritz M.G.
        • Christiansen P.
        • Jensen M.B.
        • et al.
        Gynaecomastia in 786 adult men: clinical and biochemical findings.
        Eur J Endocrinol. 2017; 176: 555-566
        • Nuttall F.Q.
        Gynecomastia as a physical finding in normal men.
        J Clin Endocrinol Metab. 1979; 48: 338-340
        • Niewoehner C.B.
        • Nuttal F.Q.
        Gynecomastia in a hospitalized male population.
        Am J Med. 1984; 77: 633-638
        • Georgiadis E.
        • Papandreou L.
        • Evangelopoulou C.
        • et al.
        Incidence of gynaecomastia in 954 young males and its relationship to somatometric parameters.
        Ann Hum Biol. 1994; 21: 579-587
        • DUNN J.F.
        • NISULA B.C.
        • RODBARD D.
        Transport of steroid hormones: binding of 21 endogenous steroids to both testosterone-binding globulin and corticosteroid-binding globulin in human plasma.
        J Clin Endocrinol Metab. 1981; 53: 58-68
        • Vermeulen A.
        Physiology of the testosterone-binding globulin in man.
        Ann N Y Acad Sci. 1988; 538: 103-111
        • Deepinder F.
        • Braunstein G.D.
        Drug-induced gynecomastia: an evidence-based review.
        Expert Opin Drug Saf. 2012; 11: 779-795
        • Ramsey J.T.
        • Li Y.
        • Arao Y.
        • et al.
        Lavender products associated with premature thelarche and prepubertal gynecomastia: case reports and endocrine-disrupting chemical activities.
        J Clin Endocrinol Metab. 2019; 104: 5393-5405
      1. Malata CM and Wong KY. Gynecomastia Surgery. In: Nahabedian MY and Neligan PC. Plastic Surgery.

        • Fitzgerald P.A.
        Gynecomastia.
        in: Papadakis M.A. McPhee S.J. Rabow M.W. Current medical diagnosis & treatment. 2022
        • Sansone A.
        • Romanelli F.
        • Sansone M.
        • et al.
        Gynecomastia and hormones.
        Endocrine. 2017; 55 (Epub 2016 May 4. PMID: 27145756): 37-44
        • Dickson G.
        Gynecomastia.
        Am Fam Physician. 2012; 85 (PMID: 22534349): 716-722
        • Brown R.H.
        • Chang D.K.
        • Siy R.
        • et al.
        Trends in the surgical correction of gynecomastia.
        Semin Plast Surg. 2015; 29: 122-130
        • Muñoz Carrasco R.
        • Alvarez Benito M.
        • Muñoz Gomariz E.
        • et al.
        Mammography and ultrasound in the evaluation of male breast disease.
        Eur Radiol. 2010; 20 (Epub 2010 Jun 23. PMID: 20571799): 2797-2805
        • Westenend P.J.
        Core needle biopsy in male breast lesions.
        J Clin Pathol. 2003; 56 (PMID: 14600134; PMCID: PMC1770095): 863-865
        • Janes S.E.
        • Lengyel J.A.
        • Singh S.
        • et al.
        Needle core biopsy for the assessment of unilateral breast masses in men.
        Breast. 2006; 15 (Epub 2005 Jul 18. PMID: 16026984): 273-275
        • Lawrence S.E.
        • Faught K.A.
        • Vethamuthu J.
        • et al.
        Beneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia.
        J Pediatr. 2004; 145 (PMID: 15238910): 71-76
      2. Chapter 384: Disorders of the Testes and Male Reproductive System. In: Jameson JL, Fauci AS, Kasper DL, Hauser SL, Longo DL, Loscalzo J. Harrison’s Principles of Internal Medicine. 20th edition.

        • Gruntmanis U.
        • Braunstein G.D.
        Treatment of gynecomastia.
        Curr Opin Investig Drugs. 2001; 2 (PMID: 11569940): 643-649
        • Baumgarten L.
        • Dabaja A.A.
        Diagnosis and management of gynecomastia for urologists.
        Curr Urol Rep. 2018; 19 (PMID: 29774423): 46
        • Nguyen P.L.
        • Alibhai S.M.
        • Basaria S.
        • et al.
        Adverse effects of androgen deprivation therapy and strategies to mitigate them.
        Eur Urol. 2015; 67 (Epub 2014 Aug 2. PMID: 25097095): 825-836
        • Schröder L.
        • Rudlowski C.
        • Walgenbach-Brünagel G.
        • et al.
        Surgical strategies in the treatment of gynecomastia grade I-II: the combination of liposuction and subcutaneous mastectomy provides excellent patient outcome and satisfaction.
        Breast care (Basel, Switzerland). 2015; 10: 184-188
        • Kanakis G.A.
        • Nordkap L.
        EAA Clin Pract guidelines-gynecomastia Eval Manag. 2019; 7: 778-793
        • Rohrich R.J.
        • Ha R.Y.
        • Kenkel J.M.
        • et al.
        Classification and management of gynecomastia: defining the role of ultrasound-assisted liposuction.
        Plast Reconstr Surg. 2003; 111 (; discussion 24-5): 909-923
        • Zavlin D.
        • Jubbal K.T.
        • Friedman J.D.
        • et al.
        Complications and outcomes after gynecomastia surgery: analysis of 204 pediatric and 1583 adult cases from a national multi-center database.
        Aesthetic Plast Surg. 2017; 41: 761-767
        • Simon B.E.
        • Hoffman S.
        • Kahn S.
        Classification and surgical correction of gynecomastia.
        Plast Reconstr Surg. 1973; 51: 48-52
        • Longheu A.
        • Medas F.
        • Corrias F.
        • et al.
        Surgical management of gynecomastia: experience of a general surgery center.
        Il Giornale di chirurgia. 2016; 37: 150-154
        • Holzmer S.W.
        • Lewis P.G.
        • Landau M.J.
        • et al.
        Surgical management of gynecomastia: a comprehensive review of the literature.
        Plast Reconstr Surg Glob open. 2020; 8: e3161-e
        • Mett T.R.
        • Pfeiler P.P.
        • Luketina R.
        • et al.
        Surgical treatment of gynaecomastia: a standard of care in plastic surgery.
        Eur J Plast Surg. 2020; 43: 389-398
        • de Souza Pinto E.B.
        • Chiarello de Souza Pinto Abdala P.
        • Montecinos Maciel C.
        • et al.
        Liposuction and VASER.
        Clin Plast Surg. 2006; 33: 107-115
        • Webster J.P.
        Mastectomy for Gynecomastia Through a Semicircular Intra-areolar Incision.
        Ann Surg. 1946; 124: 557-575
        • Morselli P.G.
        Pull-through": a new technique for breast reduction in gynecomastia.
        Plast Reconstr Surg. 1996; 97: 450-454
        • Bailey S.H.
        • Guenther D.
        • Constantine F.
        • et al.
        Gynecomastia Management: An Evolution and Refinement in Technique at UT Southwestern Medical Center.
        Plast Reconstr Surg Glob open. 2016; 4: e734
        • Shirol S.S.
        Orange Peel excision of gland: a novel surgical technique for treatment of gynecomastia.
        Ann Plast Surg. 2016; 77: 615-619
        • Thiénot S.
        • Bertheuil N.
        • Carloni R.
        • et al.
        Postero-inferior pedicle surgical technique for the treatment of grade iii gynecomastia.
        Aesthetic Plast Surg. 2017; 41: 531-541
        • Fentiman I.S.
        • Fourquet A.
        • Hortobagyi G.N.
        Male breast cancer.
        Lancet (London, England). 2006; 367: 595-604
        • Lapid O.
        • Jolink F.
        Surgical management of gynecomastia: 20 years’ experience.
        Scand J Surg. 2013; 103: 41-45
        • Steele S.R.
        • Martin M.J.
        • Place R.J.
        Gynecomastia: complications of the subcutaneous mastectomy.
        Am surgeon. 2002; 68: 210-213
        • Fricke A.
        • Lehner G.M.
        • Stark G.B.
        • et al.
        Gynecomastia: histological appearance in different age groups.
        J Plast Surg Hand Surg. 2018; 52: 166-171
        • Colombo-Benkmann M.
        • Buse B.
        • Stern J.
        • et al.
        Indications for and results of surgical therapy for male gynecomastia.
        Am J Surg. 1999; 178: 60-63
        • Azimi N.
        • Azar A.
        • Khan A.
        • et al.
        Benign breast cyst in a young male.
        Cureus. 2019; 11: e4814-e
        • Salemis N.S.
        Benign cyst of the male breast. An exceedingly rare entity that may pose a diagnostic dilemma. Management and literature review.
        Breast Dis. 2021; 40: 207-211
        • Kowalski A.
        • Okoye E.
        (StatPearls Publishing;)Breast cyst. [Updated 2021 Dec 13]. StatPearls [Internet], Treasure Island (FL)2022 (Available at:)
        • Parsian S.
        • Rahbar H.
        • Rendi M.H.
        • et al.
        Benign breast cyst without associated gynecomastia in a male patient: a case report.
        J Radiol Case Rep. 2011; 5: 35-40
        • Draghi F.
        • Tarantino C.C.
        • Madonia L.
        • et al.
        Ultrasonography of the male breast.
        J Ultrasound. 2011; 14: 122-129
        • Berg W.A.
        • Sechtin A.G.
        • Marques H.
        • et al.
        Cystic breast masses and the ACRIN 6666 experience.
        Radiol Clin North Am. 2010; 48: 931-987
        • Maimone S.
        • Ocal I.T.
        • Robinson K.A.
        • et al.
        Characteristics and Management of Male Breast Parenchymal Cysts.
        J Breast Imaging. 2020; 2: 330-335
        • Iuanow E.
        • Kettler M.
        • Slanetz P.J.
        Spectrum of Disease in the Male Breast.
        Am J Roentgenol. 2011; 196: W247-W259
        • D’Orsi C.J.
        • Sickles E.A.
        • Mendelson E.B.
        • et al.
        ACR BI-RADS®Atlas, breast imaging reporting and data system.
        American College of Radiology, Reston, VA2013
        • Kinoshita H.
        • Kashiwagi S.
        • Teraoka H.
        • et al.
        Intracystic papillary carcinoma of the male breast: a case report.
        World J Surg Oncol. 2018; 16: 15
        • Tochika N.
        • Takano A.
        • Yoshimoto T.
        • et al.
        Intracystic carcinoma of the male breast: report of a case.
        Surg Today. 2001; 31: 806-809
        • Sinha S.
        • Hughes R.G.
        • Ryley N.G.
        Papillary carcinoma in a male breast cyst: a diagnostic challenge.
        Ann R Coll Surg Engl. 2006; 88: W3-W5
        • Ravichandran D.
        • Carty N.J.
        • al-Talib R.K.
        • et al.
        Cystic carcinoma of the breast: a trap for the unwary.
        Ann R Coll Surg Engl. 1995; 77: 123-126
        • Chau A.
        • Jafarian N.
        • Rosa M.
        Male breast: clinical and imaging evaluations of benign and malignant entities with histologic correlation.
        Am J Med. 2016; 129: 776-791
        • Pandya K.A.
        • Radke F.
        Benign skin lesions: lipomas, epidermal inclusion cysts, muscle and nerve biopsies.
        Surg Clin North Am Jun. 2009; 89: 677-687
        • Ingraffea A.
        Benign skin neoplasms.
        Facial Plast Surg Clin North Am. 2013; 21: 21-32
        • Amber K.T.
        • Ovadia S.
        • Camacho I.
        Injection therapy for the management of superficial subcutaneous lipomas.
        J Clin Aesthet Dermatol. 2014; 7: 46-48
        • Gaucher S.
        • Maladry D.
        • Silitra A.M.
        • et al.
        Removal of subcutaneous lipomas: Interest of liposuction.
        J Cosmet Dermatol. 2017; 16: 400-401
        • Copeland-Halperin L.R.
        • Pimpinella V.
        • Copeland M.
        Combined liposuction and excision of lipomas: long-term evaluation of a large sample of patients.
        Plast Surg Int. 2015; 2015: 625396
        • Maciolek L.M.
        • Harmon T.S.
        • He J.
        • et al.
        Pseudoangiomatous stromal hyperplasia of the breast: a rare finding in a male patient.
        Cureus. 2019; 11 (Published 2019 Jun 17): e4923
        • Bowman E.
        • Oprea G.
        • Okoli J.
        • et al.
        Pseudoangiomatous stromal hyperplasia (PASH) of the breast: a series of 24 patients.
        Breast J. 2012; 18: 242-247
        • Jaunoo S.S.
        • Thrush S.
        • Dunn P.
        Pseudoangiomatous stromal hyperplasia (PASH): a brief review.
        Int J Surg. 2011; 9: 20-22
        • AlSharif S.
        • Alshamrani K.M.
        • Scaranelo A.
        • et al.
        Unusual Male Breast Lesions.
        J Clin Imaging Sci. 2021; 11 (Published 2021 Apr 19): 21
        • Lattin Jr., G.E.
        • Jesinger R.A.
        • Mattu R.
        • et al.
        From the radiologic pathology archives: diseases of the male breast: radiologic-pathologic correlation.
        Radiographics. 2013; 33: 461-489https://doi.org/10.1148/rg.332125208
        • Hughes L.L.
        • Styblo T.M.
        • Thoms W.W.
        • et al.
        Cellulitis of the breast as a complication of breast-conserving surgery and irradiation.
        Am J Clin Oncol. 1997; 20: 338-341
        • Mertz K.R.
        • Baddour L.M.
        • Bell J.L.
        • et al.
        Breast cellulitis following breast conservation therapy: a novel complication of medical progress.
        Clin Infect Dis. 1998; 26: 481-486
        • Rescigno J.
        • McCormick B.
        • Brown A.E.
        • et al.
        Breast cellulitis after conservative surgery and radiotherapy.
        Int J Radiat Oncol Biol Phys. 1994; 29: 163-168
        • Zippel D.
        • Siegelmann-Danieli N.
        • Ayalon S.
        • et al.
        Delayed breast cellulitis following breast conserving operation.
        Eur J Surg Oncol. 2003; 29: 327-330
        • Peters F.
        • Petersen E.E.
        • Kirkpatrick C.J.
        Isolated erythema (cellulitis) of the breast.
        Breast. 2002; 11: 484-488
        • Rahmouni A.
        • Chosidow O.
        • Mathieu D.
        • et al.
        MR imaging in acute infectious cellulitis.
        Radiology. 1994; 192: 493-496
        • Miller L.G.
        • Quan C.
        • Shay A.
        • et al.
        A prospective investigation of outcomes after hospital discharge for endemic, community-acquired methicillin-resistant and -susceptible Staphylococcus aureus skin infection.
        Clin Infect Dis. 2007; 44: 483-492
        • Dixon J.M.
        • Khan L.R.
        Treatment of breast infection.
        BMJ. 2011; 342 (Published 2011 Feb 11): d396
        • Bharat A.
        • Gao F.
        • Aft R.L.
        • et al.
        Predictors of primary breast abscesses and recurrence.
        World J Surg. 2009; 33: 2582-2586
        • Dixon J.M.
        Breast abscess.
        Br J Hosp Med (Lond). 2007; 68: 315-320
        • Christensen A.F.
        • Al-Suliman N.
        • Nielsen K.R.
        • et al.
        Ultrasound-guided drainage of breast abscesses: results in 151 patients.
        Br J Radiol. 2005; 78: 186-188
        • Fitch M.T.
        • Manthey D.E.
        • McGinnis H.D.
        • et al.
        Videos in clinical medicine. abscess incision and drainage.
        N Engl J Med. 2007; 357: e20
        • Korownyk C.
        • Allan G.M.
        Evidence-based approach to abscess management.
        Can Fam Physician. 2007; 53: 1680-1684
        • Leach R.D.
        • Eykyn S.J.
        • Phillips I.
        • et al.
        Anaerobic subareolar breast abscess.
        Lancet. 1979; 1: 35-37
        • Janis J.E.
        • Khansa L.
        • Khansa I.
        Strategies for postoperative seroma prevention: a systematic review.
        Plast Reconstr Surg. 2016; 138: 240-252
        • Marangi G.F.
        • Segreto F.
        • Morelli Coppola M.
        • et al.
        Management of chronic seromas: a novel surgical approach with the use of vacuum assisted closure therapy.
        Int Wound J. 2020; 17: 1153-1158
        • Tadych K.
        • Donegan W.L.
        Postmastectomy seromas and wound drainage.
        Surg Gynecol Obstet. 1987; 165: 483-487
        • Andrades P.
        • Prado A.
        • Danilla S.
        • et al.
        Progressive tension sutures in the prevention of postabdominoplasty seroma: a prospective, randomized, double-blind clinical trial.
        Plast Reconstr Surg. 2007; 120: 935-946
        • Shamley D.R.
        • Barker K.
        • Simonite V.
        • et al.
        Delayed versus immediate exercises following surgery for breast cancer: a systematic review.
        Breast Cancer Res Treat. 2005; 90: 263-271
        • Yilmaz K.B.
        • Dogan L.
        • Nalbant H.
        • et al.
        Comparing scalpel, electrocautery and ultrasonic dissector effects: the impact on wound complications and pro-inflammatory cytokine levels in wound fluid from mastectomy patients.
        J Breast Cancer. 2011; 14: 58-63
        • Di Martino M.
        • Nahas F.X.
        • Barbosa M.V.J.
        • et al.
        Seroma in lipoabdominoplasty and abdominoplasty: a comparative study using ultrasound.
        Plast Reconstr Surg. 2010; 126: 1742-1751https://doi.org/10.1097/PRS.0b013e3181efa6c5
        • Vidal P.
        • Berner J.E.
        • Will P.A.
        Managing complications in abdominoplasty: a literature review.
        Arch Plast Surg. 2017; 44: 457-468