title: Severe gynecomastia due to anti androgens intake: A case report and literature review.
abstract: Gynecomastia is the most bothersome side effect in men taking antiandrogens. It is exceptionally severe and distressing physically and mentally as in the reported case. A man, aged 63, with a history of a well-treated macroprolactinoma, was referred in 2004 for gynecomastia that appeared after treatment by microsurgery, radiotherapy and flutamide for a lesion suspected to be prostate cancer. Clinical examination was normal except for huge enlargement of the breasts. Mammography and breasts MRI did not show any tumor. There was not any metastasis of the supposed prostate cancer and prostatic acid phosphates were within normal ranges. Hormonal exploration showed subclinical hypogonadism [testosterone: 7.4 ng/ml (n: 3-9), FSH: 14.9 mu/ml (n: 0.7-11) and LH: 9.7 mu/ml (n: 0.8-7.6)]. Testes ultrasounds were normal. Radiological and hormonal adrenal explorations were normal [Cortisol: 76 ng/ml (n: 50-250), DHEA-S: 59 μg/ml (n: 50-560), E2:40.2 pg/ml (n < 50)]. Body scan was normal too. The discussed etiologies were post radiation subclinical hypogonadism, and treatment with anti androgens. After flutamide withdraw, there was not any sign of prostate cancer recurrence, and gynecomastia decreased significantly, but did not disappear probably because of fibrosis.
authors: Farida
authors: F
authors: Chentli
authors: Department of Endocrine and Metabolic Diseases, Bab El Oued Hospital, 5 Boulevard Said Touati Algiers, Algeria.
authors: Chentli
authors: C
authors: Farida
authors: Faiza
authors: F
authors: Belhimer
authors: Belhimer
authors: B
authors: Faiza
keywords: Aging; antiandrogens; gynecomastia; prostate cancer
references: N Engl J Med. 2007 Sep 20;357(12):1229-37
references: 17881754
references: Eur Urol. 2010 Feb;57(2):238-45
references: 19481335
references: J Sex Med. 2009 Apr;6(4):989-1000
references: 19175864
references: Endocrinol Nutr. 2009 Nov;56(9):470-4
references: 20096213
references: Curr Oncol Rep. 2004 May;6(3):209-15
references: 15066232
references: Recenti Prog Med. 2006 Feb;97(2):85-8
references: 16671273
references: Anticancer Res. 2004 Mar-Apr;24(2C):1077-81
references: 15154626
references: J Clin Endocrinol Metab. 2011 Jan;96(1):15-21
references: 21209041
references: J Sex Med. 2010 Jun;7(6):2273-2279
references: 20233285
references: J Natl Cancer Inst. 2004 Feb 18;96(4):338-9
references: 14970289