Differential Diagnosis and Workup for Male Gynecomastia: Medications: spironolactone, ketoconazole, finasteride, alcohol, opiates, INH, steroids (testosterone, estrogen), atypical antipsychotics, essential oils (thanks Meghan for sharing details on lavender and tea tree oils!), androgen deprivation Hypogonadism: look for signs of decreased muscle mass, body hair, and testicular size, change in libido Malignancy: - Breast cancer (increased risk if +FH, BRCA mutation, Klinefelter syndrome) - Testicular tumors (especially those that secrete beta-hcg or estradiol) - Adrenal tumors Persistent pubertal gynecomastia (usually longstanding history of gynecomastia even as an adolescent) Systemic disease Cirrhosis Renal disease Thyroid disease #Gynecomastia #Differential #Diagnosis #Workup #Male
