Classification of Endocrine Gynecomastia

• Physiological Gynecomastia

• Neonatal

• Pubertal

• Aging

• Pathological Gynecomastia

• Testosterone Deficinecy

• Congenital Defects:

• Anorchia

• Klinefelter Syndrome

• Androgen Resistanse Testicular Feminization and Reifenstein

• Defects in Testosterone Sunethesis or 5 alpha-redutase, CAH 17 hydroxylase

• Secondary Testicular Failure: Orchitis, Trauma, Castration, Renal Failure

• Hypogonaotropic Hypogonadism: Kallman, Hemochromatosis, Tumor, Prolactinoma, Autoimmune, Vascular

• Increased Estrogen Production

• Incresed Testicular Production HCG: Seminoma, Embryonlal, Choriocarcinoma

• Ectopic HCG: Hepatoblastoma, Lung, Gastric, Renal Carcinoma

• Leydig and Sertoli Cell Tumors (Carney Complex, Peurz-Jegher’s Syndrome)

• True Hermaphroditism

• Feminizing Adrenal Tumors

• Increased Substrate Extraglandular Aromatse: Liver Disease, Adrenal Disease, Strvation

• Increased Extraglandular Aromatase

• Incresed Free Estrogen/Testosterone: Thyrotoxicosis associated increased SBG

• Target Organ: Androgen/Estrogan Receptor Affinity/Activity

• Drugs

• Idiopathic