Gynecomastia in childhood and adolescence: At a glance

Gynecomastia, defined as a benign proliferative of the male’s breast glandular tissue, is a common finding in boys during childhood and adolescence, and usually caused by increased estrogen activity, decreased testosterone activity, or the use of numerous medications.  Although most cases are benign and self-limiting, it may represent signs of an underlying systemic diseases, drug induced or even male breast cancer.  Understanding its pathogenesis is crucial to distinguish normal developmental variant from pathological causes.  A stepwise approach that includes clinical assessment, imaging and laboratory testing to exclude neoplasia and endocrinopathies may facilitate cost effective diagnosis. This review will highlight the pathophysiology, etiology, diagnosis and the various medical and surgical therapies.