HORMONE EXCRETION IN LIVER DISEASE AND IN GYNECOMASTIA

Abstract

GYNECOMASTIA occurs in 7 to 15 per 100,000 otherwise apparently normal adult men (1, 2). Transient gynecomastia is not uncommon in the new-born (3) and occurs during puberty in about 50 per cent of boys. It has been reported in association with the following diseases: adrenocortical tumors (4, 5, 6), chorioepitheliomas (7), other testicular tumors (8, 9), degeneration of the seminiferous tubules (10, 11), thyrotoxicosis (12), malnutrition (13, 14), paraplegia (15), and liver disease (16, 17, 18). It has been observed also following administration of desoxycorticosterone acetate (19), adrenal cortical extract (20), and testosterone (21, 22). The question may be raised as to whether or not the development of gynecomastia under these various circumstances is dependent on the operation of a common mechanism. Because of the influence of estrogen upon mammary ductal growth and the frequent occurrence of gynecomastia in men treated with, or otherwise exposed to estrogens, this hormone has been suspected to be involved in the pathogenesis of all forms of gynecomastia. In an attempt to investigate this matter, two groups of patients were studied; 1) subjects with gynecomastia occurring in the absence of other abnormality (“primary” gynecomastia) or in association with some condition other than disease of the liver; and 2) subjects with liver disease, with and without gynecomastia.