Causes of gynecomastia

[smithers]

I went to see my family doctor today and informed him that I booked surgery. He asked if the surgeon was going to run test prior to surgery to find out the cause of my gynecomastia.

My surgeon is not, see he has had ordered the following tests: TSH, CBC, Prolactin, LH, FSH & Growth Hormone.

He said that if the  gynecomastia is caused by a pituitary tumors that produce prolactin, surgery would be a temp solution and therefore, the gland would come back. I have had gynecomastia since I was 11/12 and I am now in my 30s. Is it possible that the cause is Prolactinoma in nature? Docs please help I am a Little freaked out at this moment.

[Dr. Elliot Jacobs]

If you have had gyne, onset in puberty and stable until you are in your 30's, the odds are that it is not a prolactinoma.  However, if you had very recent onset of gyne, then prolactinoma should be considered as one (of a great many) possible causes.

As a routine, I do not order a complete hormonal workup for every gyne patient that I see.  Most hormonal results come back normal or near normal.  Unless I have some clinical suspicion of a problem, the tests are largely unnecessary and add more expense for the patient.

However, I never argue with a doctor or a patient if they want complete hormonal test "just to make sure." --it cannot hurt.

Dr Jacobs

[smithers]

Thanks Dr. Jacobs, Yes, I have had my gyne since puberty and it has been stable until now. I will do the tests to please my doctor and I should get the results prior to my March pre-opp appointment with my surgeon. I just want to get this all behind me as soon as possible.

[Grandpa Bambu]

Please help I am a Little freaked out at this moment.

As Dr. Jacobs mentioned, if your G has been stable for that long, then the chances of it being a prolactinoma are slim and the chance of your G returning are also very slim...

I developed my G at 10 years old (give or take a year). I had surgery at 41 and am 45 now. Actually it has been 4 years this past Monday since the procedure. Four years and no sign of it coming back!!!

I hope this is of some solace for you... 

GB

[Plarkin]

is the above statement true, that if you had it at early adolesence and don't get it operated on for 30 years, is is less likely to reoccur? I haven't heard that one. Didn't Merle have a regrowth after having it for quite some time?

[Paa_Paw]

Merle had rather profoundly large breasts. His first surgery stopped short of removing enough  tissue in some areas so he had a second surgery some time later. He did not have regrowth, but he did have some additional tissue removed to improve the overall contour.

I think that anyone would be wise to hope that they are equally fortunate.

A second procedure to remove additional tissue is much easier to deal with than attempting to cover up the fact that too much tissue was removed and the skin is now adherant to the underlying muscle.

This is an issue that has been covered many times.

Wth respect to the various lab studies, Dr. Jacobs covered that quite well.