Benign symmetric lipomatosis of the male breast: an unusual mimic of gynaecomastia

Abstract

<h3>Introduction</h3> Benign symmetric lipomatosis is a rare disease. Its aetiopathogenesis is uncertain although it has been linked to chronic alcoholism, disturbance in lipid metabolism, and autonomic and mitochondrial dysfunctions. Familial and syndromic associations have also been made. Its main characteristic is the overgrowth of fat in form of an unencapsulated lesion. Most of the cases reported are in the head and neck region. We report a case that occurred in the breasts. <h3>Patient</h3> A 62-year-old man presented to our hospital with a 3 year history of painless progressive, soft swellings of the breasts bilaterally. History, systemic examination, biochemical and radiological assessment did not reveal anything suggestive of abnormal lipid metabolism or of liver or endocrine disorders. He was not on any medications except for the here oft used herbal blends. A clinical diagnosis of gynaecomastia was made. Partial mastectomy with sparing of the nipple-areolar complex area was done. Grossly, we found huge unencapsulated masses measuring: right (30 × 30 × 13cm) and left (31 × 30 × 12cm). Cut sections revealed homogeneous, yellow, greasy tissues. Microscopy showed unencapsulated sheets of mature adipocytes with scanty, delicate, fibro-vascular connective tissue stroma exclusive of any epithelial elements. The patient had done very well since discharge from the hospital. <h3>Conclusion</h3> Benign symmetric lipomatosis may occur in the male breast and thus constitute a mimic of bilateral gynaecomastia.