A 39-year-old male presents with gynaecomastia.
Which of the following is the most likely cause of his gynaecomastia?
Congenital adrenal hyperplasia (CAH)
Hypopituitarism
Hypothyroidism
Prolactinoma
Seminoma(This is the correct answer)
Gynaecomastia is due to a perturbation in the testosterone to oestradiol ratio.
Neither hyperprolactinaemia nor hypopituitarism disturb this ratio and are rarely associated with
gynaecomastia.
Unlike hyperthyroidism, hypothyroidism is not a cause. CAH is not a cause.
However, gynaecomastia may be a presenting symptom of a seminoma and may arise due to human
chorionic gonadotropin (HCG) secretion.