title: Gynecomastia disclosing diagnosis of Leydig cell tumour in a man with thalassemia, secondary hypogonadism and testis microlithiasis.
abstract: Aim of this paper is to report about a 35-year old man suffering from beta-Thalassemia major and longstanding untreated hypogonadotropic hypogonadism, who was referred because of a recent onset and painful bilateral gynecomastia, with no palpable testicular masses. Due to the finding of a solid mass at left testis ultrasonography, monolateral testicular exeresis was performed and histology revealed a Leydig Cell Tumour and testicular microlithiasis. Post-surgical restoration of testosterone/estradiol ratio under testosterone therapy was followed by a very rapid reduction of gynecomastia. Our report confirms the usefulness of scrotal ultrasonography for finding an occult testicular tumour in a patient with painful and recent onset bilateral gynecomastia and underlines: a) the important role of testosterone/estradiol ratio in the pathophysiology of gynecomastia; b) the questionable significance of testicular microlithiasis as marker of testis tumours; c) the possible association between beta-Thalassemia and tumoral pathologies.
authors.affiliation: Department of Pediatrics, University of Messina, Messina, Italy. wasniewska@yahoo.it
authors.forename: Malgorzata
authors.initials: M
authors.lastname: Wasniewska
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Raiola
authors.forename: Arrigo
authors.initials: A
authors.lastname: Teresa
authors.forename: Maria Concetta
authors.initials: MC
authors.lastname: Galati
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Zirilli
authors.forename: Maria Ausilia
authors.initials: MA
authors.lastname: Catena
authors.forename: Giorgio
authors.initials: G
authors.lastname: Ascenti
authors.forename: Stefania
authors.initials: S
authors.lastname: Arasi
authors.forename: Filippo
authors.initials: F
authors.lastname: De Luca
mesh_terms: D000328:Adult; D006177:Gynecomastia / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D006537:Heptanoates / Q000627:therapeutic use; D006801:Humans; D007006:Hypogonadism / Q000188:drug therapy / Q000453:epidemiology; D007984:Leydig Cell Tumor / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D020347:Lithiasis / Q000453:epidemiology; D008297:Male; D013733:Testicular Diseases / Q000453:epidemiology; D013736:Testicular Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging; D014463:Ultrasonography; D017086:beta-Thalassemia / Q000453:epidemiology
chemical_list: D006537:Heptanoates