Gynecomastia with a Testicular Mass

The finding of non-painful bilateral breast swelling is classic for gynecomastia.

A thorough history and physical examination are required to determine the underlying etiology.

While lymphoma may present with a testicular mass, it is unlikely to cause gynecomastia. Exogenous testosterone and Klinefelter’s syndrome are possible explanations for gynecomastia, but do not present with a testicular mass.

A Sertoli cell tumor, however, produces androgen, which explains both the testicular mass and the gynecomastia.

While breast cancer is in the differential, it is less likely as the swelling is bilateral; testicular metastases are rare.

Hotko YS. Male breast cancer: clinical presentation, diagnosis, treatment. Exp Oncol. 2013;35:303-310.

Swerdloff RS, Ng C. Gynecomastia: Etiology, Diagnosis and Treatment. [Updated June 20, 2011]. In: De Groot LJ, Beck-Peccoz P, Chrousos G, et al, eds. Endotext. South Dartmouth, MA:, Inc.; 2000-2015.

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