Concurrent male gynecomastia and testicular hydrocele after imatinib mesylate treatment of a gastrointestinal stromal tumor.
We report a gastrointestinal stromal tumor (GIST) patient with male gynecomastia and testicular hydrocele after treatment with imatinib mesylate. A 42 yr-old male patient presented for management of hepatic masses. Two years earlier, he had undergone a small bowel resection to remove an intraabdominal mass later shown to be a GIST, followed by adjuvant radiation therapy. At presentation, CT scan revealed multiple hepatic masses, which were compatible with metastatic GIST, and he was prescribed imatinib 400 mg/day. During treatment, he experienced painful enlargement of the left breast and scrotal swelling. Three months after cessation of imatinib treatment, the tumors recurred, and, upon recommencing imatinib, he experienced painful enlargement of the right breast and scrotal swelling. He was diagnosed with male gynecomastia caused by decreased testosterone and noncommunicative testicular hydrocele. He was given androgen support and a hydrocelectomy, which improved his gynecomastia. The mechanism by which imatinib induces gynecomastia and hydrocele is thought to be associated with an inhibition of c-KIT and platelet-derive growth factor. This is the first report, to our knowledge, describing concurrent male gynecomastia and testicular hydrocele after imatinib treatment of a patient with GIST.
Kim
Hawk
H
Division of Hematology-Oncology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Chang
Heung-Moon
HM
Ryu
Min-Hee
MH
Kim
Tae-Won
TW
Sohn
Hee-Jung
HJ
Kim
So-Eun
SE
Kang
Hye-Jin
HJ
Park
Sarah
S
Lee
Jung-Shin
JS
Kang
Yoon-Koo
YK
D000328:Adult; D000728:Androgens / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001549:Benzamides; D046152:Gastrointestinal Stromal Tumors / Q000188:drug therapy*; D006177:Gynecomastia / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D006801:Humans; D000068877:Imatinib Mesylate; D008297:Male; D010879:Piperazines / Q000009:adverse effects* / Q000627:therapeutic use; D011743:Pyrimidines / Q000009:adverse effects* / Q000627:therapeutic use; D006848:Testicular Hydrocele / Q000139:chemically induced* / Q000150:complications / Q000188:drug therapy; D013737:Testis / Q000000981:diagnostic imaging / Q000187:drug effects / Q000473:pathology; D014463:Ultrasonography
D000728:Androgens; D000970:Antineoplastic Agents; D001549:Benzamides; D010879:Piperazines; D011743:Pyrimidines; D000068877:Imatinib Mesylate