Gynecomastia as a Presenting Sign of Fibrolamellar Carcinoma of the Liver

Abstract

Gynecomastia is generally a benign occurrence in 39% to 67% of the normal adolescent male population.1,2 Although the etiology of the breast development is not entirely clear, it may be due to a transient increase in serum estradiol leading to an increase in the estradiol to testosterone ratio. Gynecomastia in adolescent boys may also be associated with a variety of pathologic conditions in which there is an elevation in the estradiol to testosterone ratio. Examples of these conditions include Klinefelter syndrome, congenital anorchia, androgen resistance, orchitis, trauma, congenital adrenal hyperplasia, thyrotoxicosis, starvation, cirrhosis, testicular tumors, adrenal tumors, and primary liver carcinoma.3