Testicular tumours presenting as gynaecomastia

Aim: Gynaecomastia is the commonest benign breast condition seen in men. It is usually due to age, co-existing disease, drugs or idiopathic factors. Rarely is the cause a testicular tumour. We have assessed those men who were subsequently diagnosed as having a testicular tumour in a population of men referred to a specialist breast surgeon. Methods: A retrospective review of 175 men who had presented with breast enlargement and/or ‘lumps’ over seven years (1993–2000) to a specialist breast surgeon was performed. All patients were investigated by a protocol including biochemical assessment. Results: 175 men, median age 44 years (range 18–89) who presented to the breast clinic were assessed. 127 men had gynaecomastia (39 bilateral), 8 had breast cancer and 4 had testicular cancer. Of the men with testicular tumours, two had bilateral gynaecomastia; a testicular mass was palpable in two and the diagnosis confirmed on scrotal ultrasound in all four. Conclusion: The possibility of a testicular tumour must be considered in any male presenting with gynaecomastia. Clinical testicular examination is essential and the determination of serum tumour markers useful in the overall assessment of those presenting with ‘true gynaecomastia’.