title: Gynaecomastia: an unusual presenting symptom of bladder cancer.
abstract: A 74-year-old man presented to the outpatient clinic with painful gynaecomastia. A detailed physical examination to sort out possible causes of the gynaecomastia, including intracranial tumour, liver cirrhosis, hyperthyroidism, and adrenal and testicular tumour, was negative. No offending agent was found in his medication list. A CT scan of the head and ultrasound of the scrotum did not show any mass lesion. His serum β-human chorionic gonadotropin (β-hCG) and oestradiol levels were elevated. A CT scan of the abdomen and pelvis revealed bladder wall thickening with soft tissue mass. A cystoscopic biopsy confirmed transitional cell carcinoma with muscle invasion. The patient was started on chemotherapy but responded poorly. This case report describes the β-hCG and oestradiol-secreting transitional cell carcinoma of the bladder presenting as gynaecomastia in an older man.
authors.affiliation: Texas Tech University, Amarillo, Texas, USA.
authors.forename: Mashrafi
authors.initials: M
authors.lastname: Ahmed
authors.affiliation: Texas Tech University, Amarillo, Texas, USA.
authors.forename: Aleem
authors.initials: A
authors.lastname: Kanji
authors.affiliation: Texas Tech University, Amarillo, Texas, USA.
authors.forename: Tahmina
authors.initials: T
authors.lastname: Begum
mesh_terms: D000368:Aged; D001940:Breast / Q000473:pathology*; D002295:Carcinoma, Transitional Cell / Q000097:blood / Q000150:complications / Q000175:diagnosis*; D018997:Chorionic Gonadotropin, beta Subunit, Human / Q000097:blood* / Q000378:metabolism; D004958:Estradiol / Q000097:blood* / Q000378:metabolism; D006177:Gynecomastia / Q000097:blood / Q000175:diagnosis* / Q000209:etiology; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed; D001743:Urinary Bladder / Q000473:pathology*; D001749:Urinary Bladder Neoplasms / Q000097:blood / Q000150:complications / Q000175:diagnosis*
chemical_list: D018997:Chorionic Gonadotropin, beta Subunit, Human; D004958:Estradiol