Severe Pubertal Gynaecomastia

Abstract

Abstract:  A 15-year-old adolescent male severe and persistent pubertal gynaecenasts presented to highlight the clinical presentation and management challenges of the condition. The patient was  well built forage with a weight of 25kg, height of 66cm and a BMT of 27kg/m. He had bilateral  breast enlargement at Tanner stage IV with milky discharge from both breasts. Hormone profile showed normal levels of scrum follicle stimulating hormone, leutinising hormorne and testoterone. Prolactin,  progesterone and oestradiol levels were elevated. No pituitiary mass  was demonstrated on brain computed tomography scan. He as treated medically with Danazol (200mg) for six months and bromouripcinc (12.5mg socre) for two months with minimal response. It was offered reduction Data plasty, but the parents declined Severe gynaecomastia in a pubescent male poses a great management challenge. Medical treatment is often unsuccessful, with surgerys lacing the best option. General unacceptability of surgery in our environment poses a further challenge.