Idiopathic gynaecomastia in twins: a case report

S.V. Kumar, K. Lakshmi Kumari, P.V.S.S. Vijaya Babu, K. Asha Latha, P. Kusuma Kumari


Gynaecomastia is a common pathological condition of breast seen in men. This is defined as benign enlargement of breast tissue in males. It was first described by Palus Aegineta (AD 635-690). Herewith we are presenting cases of 14 year old twins attending the surgical O.P.D with bilateral enlarged breasts and pain. A diagnosis of pubertal gynaecomastia was made with no evidence of malignancy by histopathological examinations and mammography. One boy with 5 x 6 cm of right breast and 2 x3 cm of left breast was treated by subcutaneous mastectomy. Other boy had only enlargement of nipple and areola. He was reassured and sent home without surgical intervention. A rare case of idiopathic gynaecomastia in pubertal twins is described here.


Gynaecomastia, Oestrogen, Liposuction, Subcutaneous mastectomy

Full Text:



Braunstein GD, Gynaecomastia. N Engl J Med 2007; 357(12); 1229-1237.

Georgiadis E, Papaudreaul Evangelopoulouc, et al. Incidence of gynaecomastia in 954 young males and its relation to somatic parameter, Ann Hum Bio 1994; 21(6): 579-587.

Braunstein GD, Aromatase and Gynaecomastia, Endocrn Relat Cancer 1999; 6(2):315-324.

Lee PA. The relationship of concentration of serum hormones to pubertal gynaecomastia. J Paediatr 1975;86:212-5.

LaFranchi SH, Parlow AF, Lippe BM, Coytupa J, Kaplan S. Pubertal gynaecomastia and transient elevation of serum oestradiol levels. Am J Dis Child 1975;129:927-31.

Moore DC, Schlaepfer LV, Paunier L, Sizonenko PC. Hormonal changes during puberty vs transient pubertal gynaecomastia: abnormal androgens in oestrogen ratio. J Clin Endocrinol Metab 1984;58:492-9.

Large DM, Anderson DC. Twenty-four hour profiles of circulating androgens and oestrogens in male puberty with and without gynaecomastia. Clin Endocrinol 1979;11:505-21.

Biro FM, Lucky AW, Huster GA, Morrison JA. Hormonal studies and physical maturation in adolescent gynaecomastia. J Paediatr 1990;116:450-5.

Braunstein GD, Gynaecomastia. N Engl J Med 1993; 328: 490-5.

Nordt CA, Divasta AD, GM in Adolescent, Curr open Pediatr 2008 ; 20(4): 375- 382.

Bular J, Mowszowicz I, Schaison G. Increased aromatase activity in pubic skin fibroblasts from patients with isolated gynaecomastia. J Clin Endocrinol Metab 1987;64:618-23.

Annon. Case records of the Massachusetts General Hospital: Case 12-2000. N Engl J Med 2000;342: 1196-204.

Nagi DK, Jones WG, Belchetz PE.Gynaecomastia caused by a primary mediastinal seminoma. Clin Endocrinol 1994;40:545-8.

Reznik Y, Rieu M, Kuhn JM, Mandard JC, Bottet p, Lemonnier D, et al. Luteinizing hormone regulation by sex steroids in men with germinal and Leydig cell tumours. Clin Endocrinol 1993; 38:487-93.

Forst T, Beyer J, Cardes U, Pfutzner A, Kustner E, Moll R, et al. Gynaecomastia in a patient with an hCG producing giant cell carcinoma of the lung. Case report. Exp Clin Endocrinol Diab 1995;103:28-32.

Aiman J, Brenner PF, Mac Donald PC. Androgen and oestrogen production in elderly men with gynaecomastia and testicular atrophy after mumps orchitis. J Clin Endocrinol Metab 1980;50:380-6.

Smyth CM, Bremner WJ. Klinefelter’s syndrome. Arch intern Med 1998;158:1309-14.

Aki FT, Tekin MI, Ozen H. Gynaecomastia as a complication of chemotherapy for testicular germ cell tumours. Urology 1996;48:944-6.

Aegineta P, On breast resembling the female in adam F (translated) The Seven Books of Paulus Aeginata London; Sydenhams society 1846;2:334-335.

Sandal F, Kieppec Amland PF, Surgical treatment of Gynaecomastia. Five years experience with liposuction. Scand J Plast Recons Surg hand surg 1994;28:128-130.

Madick RA, Gynaecomastia Liposuction and Excision (review) Clin Plastic Surg 1991;18;815-822.