Gynecomastia - Differential Diagnosis Algorithm
No Testicular Mass on Ultrasound
• Adrenal Neoplasm
• Increased Extraglomerular Aromatase Activity
• Liver Disease
Testicular Mass on Ultrasound
• Leydig Cell Tumor
• Sertoli Cell Tumor
No Testicular Mass on Ultrasound
• Extragonadal Germ Cell Tumor
• HCG Secreting Non-Trophoblastic Neoplasm
Testicular Mass on Ultrasound
• Testicular Germ Cell Tumor
Increased T4, Decreased TSH
• Hyperthyroidism
Increased Testosterone
• Testicular Germ Cell Tumor
Normal T4 and TSH
• Androgen Resistance
Decreased Testosterone
• Hypogonadism
• Klinefelter's Syndrome
• Kallman's Syndrome
• Testicular Torsion
• Testicular Trauma
• Congenital Anorchia
• Viral Orchitis
Increased Prolactin
• Prolactin Secreting Tumor
Normal Prolactin
• Non-Tumor Secondary Hypogonadism
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