OBJECTIVE:To present two new cases of gynecomastia as the initial manifestation of hyperthyroidism. METHODS:We describe detailed case reports of two men with breast enlargement who were found to have hyperthyroidism, and we review the related literature. RESULTS:Two men sought medical assistance because of unilateral tender gynecomastia. In one of these patients, thyroid, gonadal, and prostate examinations showed normal findings at the time of initial assessment, and symptoms of hyperthyroidism developed later. In our other patient with gynecomastia, other symptoms of hyperthyroidism--for example, nervousness, irritability, palpitations, and fatigue--had been present for a prolonged period but had been considered "normal" by the patient. In both patients, the hyperthyroidism was treated with radioiodine. Breast pain disappeared in both patients, and breast enlargement disappeared in one patient and was decreased in the other patient after euthyroidism was achieved. Review of the literature disclosed only two similar cases. CONCLUSION:Because of the rarity of gynecomastia as the initial symptom of hyperthyroidism, we believe that thyroid function tests are not indicated in the workup of patients whose major complaint is gynecomastia.

译文

目的:介绍两例新的男性乳房发育症为甲状腺功能亢进症的初步表现。
方法:我们描述了两名发现患有甲状腺功能亢进症的男性乳房增大的详细病例报告,并复习了相关文献。
结果:两名男子因单侧嫩女性乳房发育症而寻求医疗救助。在其中一名患者中,甲状腺,性腺和前列腺检查在初次评估时显示正常,而甲状腺功能亢进症的症状随后出现。在我们的另一例男性乳房发育患者中,甲状腺功能亢进症的其他症状(例如神经质,烦躁不安,心pit和疲劳)长期存在,但被患者视为“正常”。两名患者均接受放射性碘治疗甲亢。甲状腺功能亢进后,两名患者的乳房疼痛均消失,一名患者的乳房肿胀消失,另一名患者的乳房肿胀减轻。文献回顾仅揭示了两个相似的情况。
结论:由于女性乳房发育症是甲状腺机能亢进的最初症状,因此我们认为主要症状是女性乳房发育症的患者在检查中并未进行甲状腺功能检查。

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