Accidental gynecomastia in children

Abstract

Any palpable breast tissue in men is abnormal except during: the neonatal period, adolescence and in elderly age. Gynecomastia in prepubertal children may be due to enhanced endogenous oestrogen production, drugs or unknown causes. After the onset of puberty gynecomastia may also be due to a deficiency of testosterone. Young men and boys are particularly sensitive to oestrogens and may develop gynecomastia from exposure to industrial oestrogen, to creams containing oestrogens, to antiandrogens or to unrecognized endocrine substances. Furthermore gynecomastia and others pubertal disorders in males and females may be due to ingestion of food containing oestrogens or oestrogenlike substances; many “epidemics” of gynecomastia among children have been described. Hormones ingested by meat can cause breast enlagement and other deleterious immediate or long term effects. In particular it is a common concern among paediatricians and endocrine specialists that environmental and dietary “contaminants” may interfere with the pubertal development. In the evaluation of all this data we can not ignore the toxic effects of contamination may be having both in the short term but, more particularly, in the long term in terms of morbidity, mortality and therefore social costs.