Fluoxymesterone-induced gynaecomastia in a patient with childhood aplastic anaemia

Gynaecomastia is a benign condition characterised by enlargement of the male breast. Drug-induced gynaecomastia merits deep consideration as it may account for as many as 25% of all cases of gynaecomastia in adults. Although the mechanism is not fully clear, some mechanisms include oestrogen-like ac...

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Bibliographic Details
Published in:BMJ case reports 2015-05, Vol.2015, p.bcr2014207474
Main Authors: Lo, Tom Edward Ngo, Andal, Zillien C, Lantion-Ang, Frances Lina
Format: Article
Language:English
Subjects:
Adult
Age
Anabolic Agents - administration & dosage
Anabolic Agents - adverse effects
Androgens
Anemia
Anemia, Aplastic - blood
Anemia, Aplastic - drug therapy
Asia
Biopsy
Bone marrow
Breasts
Directive Counseling
Findings That Shed New Light on the Possible Pathogenesis of a Disease or an Adverse Effect
Fluoxymesterone - administration & dosage
Fluoxymesterone - adverse effects
Gynecomastia - chemically induced
Gynecomastia - psychology
Humans
Male
Other Asian
Physiology
Sexual Maturation
Surgery
Testosterone
Thyroid gland
Treatment Outcome
Tumors
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Summary:Gynaecomastia is a benign condition characterised by enlargement of the male breast. Drug-induced gynaecomastia merits deep consideration as it may account for as many as 25% of all cases of gynaecomastia in adults. Although the mechanism is not fully clear, some mechanisms include oestrogen-like activities, stimulation of testicular production of oestrogens, inhibition of testosterone synthesis or blockade of androgen action. Anabolic steroids, in particular when used during the pubertal stage, may cause significant irreversible gynaecomastia. We report a case of 28-year-old Filipino man with persistent gynaecomastia from fluoxymesterone used for aplastic anaemia during his prepubertal stage. Hormonal work ups for gynaecomastia all turned out normal, thus isolating the drug as the cause. The patient was unable to undergo breast reconstruction surgery due to haematological contraindications, but eventually referred to psychiatry for counselling. This case will highlight the paradoxical effect of androgenic steroid used during childhood on male breast proliferation during puberty.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2014-207474