Gynecomastia: an uncommon, destabilizing condition of the male adolescent. our therapeutic choice

Gynecomastia: an uncommon, destabilizing condition of the male adolescent. our therapeutic choice


  • Massimo Pinelli Department of Plastic surgery, Policlinico di Modena University of Modena and Reggio Emilia, Italy.
  • Federico De Maria a:1:{s:5:"en_US";s:85:"Unit of Plastic Surgery, Policlinico di Modena, Università di Modena e Reggio Emilia";}
  • Pierluca Ceccarelli Department of Pediatric surgery, Policlinico di Modena University of Modena and Reggio Emilia, Italy.
  • Barbara Pedrieri Department of Pediatrics, Policlinico di Modena University of Modena and Reggio Emilia, Italy.
  • Maria Anastasia Bianchini Department of Pediatric surgery, Policlinico di Modena University of Modena and Reggio Emilia, Italy.
  • Lorenzo Iughetti Department of Pediatrics, Policlinico di Modena University of Modena and Reggio Emilia, Italy.
  • Giorgio De Santis Department of Plastic surgery, Policlinico di Modena University of Modena and Reggio Emilia, Italy.


Gynecomastia, Primary ginecomastia


Gynecomastia is the benign enlargement of breast’s the glandular tissue in male population. Gynecomastia can involve fatty and/or glandular tissue. At the basis of pediatric gynecomastia there is a multifactorial imbalance in the ratio of estrogen to androgens tissue levels. In more than 95% of the cases gynecomastia development is idiopathic. Secondary causes of gynecomastia in adolescents are relatively rare (less than 5%) and may arise from uncommon pathological conditions. Gynecomastia is self-limited and regresses in 1-3 years in 84%, 47% and 20% of adolescents with mild, moderate and severe gynecomastia. The correct first line of therapy is observation and reassurance in the treatment of mild cases. In order to manage adolescent gynecomastia is advised to adopt a tailored therapy. Despite gynecomastia is a common condition only few adolescents need cosmetic or antalgic treatment. Medical therapy should be considered in patient with emotional distress or psychological limitation on normal activities. Finally, if gynecomastia does not go in remission after two years surgical procedures should be performed. The aim of this article is to be an updated discussion of pubertal gynecomastia in every way and report our surgical experience with a retrospective study. In conclusion surgical treatment of this condition is a quiet rare procedure but, in according to global literature we demonstrated that it is a safe surgery with low rate of complications.


Braunstein GD. Gynecomastia. N Engl J Med. 2007;357(12):1229-1237. doi:10.1056/NEJMcp070677

Coopey SB, Kartal K, Li C, et al. Atypical ductal hyperplasia in men with gynecomastia: what is their breast cancer risk? Breast Cancer Res Treat. 2019;175(1):1-4. doi:10.1007/s10549-018-05117-4

Rahmani S, Turton P, Shaaban A, Dall B. Overview of Gynecomastia in the Modern Era and the Leeds Gynaecomastia Investigation Algorithm. Breast J. 2011;17(3):246-255. doi:10.1111/j.1524-4741.2011.01080.x

Waltho D, Hatchell A, Thoma A. Gynecomastia Classification for Surgical Management. Plast Reconstr Surg. 2017;139(3):638e-648e. doi:10.1097/PRS.0000000000003059

Choi BS, Lee SR, Byun GY, Hwang SB, Koo BH. The Characteristics and Short-Term Surgical Outcomes of Adolescent Gynecomastia. Aesthetic Plast Surg. 2017;41(5):1011-1021. doi:10.1007/s00266-017-0886-z

Kumanov P, Deepinder F, Robeva R, Tomova A, Li J, Agarwal A. Relationship of Adolescent Gynecomastia with Varicocele and Somatometric Parameters: A Cross-Sectional Study in 6200 Healthy Boys. J Adolesc Heal. 2007;41(2):126-131. doi:10.1016/j.jadohealth.2007.03.010

Lee EJ, Chang YW, Oh JH, Hwang J, Hong SS, Kim HJ. Breast lesions in children and adolescents: Diagnosis and management. Korean J Radiol. 2018;19(5):978-991. doi:10.3348/kjr.2018.19.5.978

Amalfi A, Sommer N. Gynecomastia. In: Chung KC, ed. Grabb and Smith’s Plastic Surgery. Eight edit. Wolters Kluwer; 2020:575-581.

Narula HS, Carlson HE. Gynaecomastia—pathophysiology, diagnosis and treatment. Nat Rev Endocrinol. 2014;10(11):684-698. doi:10.1038/nrendo.2014.139

Soliman AT, De Sanctis V, Yassin M. Management of Adolescent Gynecomastia: An Update. Acta Biomed. 2017;88(2):204-213. doi:10.23750/abm.v88i2.6665

Moore DC, Schlaepfer L V., Paunier L, Sizonenko PC. Hormonal Changes during Puberty: V. Transient Pubertal Gynecomastia: Abnormal Androgen-Estrogen Ratios*. J Clin Endocrinol Metab. 1984;58(3):492-499. doi:10.1210/jcem-58-3-492

Bidlingmaier F, Knorr D. Plasma testosterone and estrogens in pubertal gynecomastia. Zeitschrift f�r Kinderheilkd. 1973;115(1):89-94. doi:10.1007/BF00438995

Dejager S, Bry-Gauillard H, Bruckert E, et al. A Comprehensive Endocrine Description of Kennedy’s Disease Revealing Androgen Insensitivity Linked to CAG Repeat Length. J Clin Endocrinol Metab. 2002;87(8):3893-3901. doi:10.1210/jcem.87.8.8780

Gill S, Peston D, Vonderhaar BK, Shousha S. Expression of prolactin receptors in normal, benign, and malignant breast tissue: an immunohistological study. J Clin Pathol. 2001;54(12):956-960. doi:10.1136/jcp.54.12.956

Gutzman JH, Miller KK, Schuler LA. Endogenous human prolactin and not exogenous human prolactin induces estrogen receptor α and prolactin receptor expression and increases estrogen responsiveness in breast cancer cells. J Steroid Biochem Mol Biol. 2004;88(1):69-77. doi:10.1016/j.jsbmb.2003.10.008

Czajka-Oraniec I, Zgliczyński W. Phenotype of patients with gynecomastia. Endokrynol Pol. 2008;59(2):131-139.

Yüce Ö, Tepe D, Erel Ö. Impaired dynamic thiol/disulfide homeostasis in pubertal gynecomastia. Int J Adolesc Med Health. November 2018. doi:10.1515/ijamh-2018-0062

Rosen H, Webb ML, DiVasta AD, et al. Adolescent Gynecomastia: not only an obesity issue. Ann Plast Surg. April 2010:1. doi:10.1097/SAP.0b013e3181dba827

Freeman RM. Gynecomastia: An Endocrinologic Complication of Hemodialysis. Ann Intern Med. 1968;69(1):67. doi:10.7326/0003-4819-69-1-67

Shahriari M, Ghasemi K, Bordbar M, Shakibazad N. Gynecomastia as a late complication of childhood cancer and its treatment that can affect the quality of life of male survivors. Semin Oncol. 2019;46(2):155-159. doi:10.1053/j.seminoncol.2019.04.003

Nishiyama M, Makino S, Iwasaki Y, et al. CRH mRNA expression in the hypothalamic paraventricular nucleus is inhibited despite the activation of the hypothalamo-pituitary-adrenal axis during starvation. Brain Res. 2008;1228:107-112. doi:10.1016/j.brainres.2008.06.065

Swerdloff RS, Ng CM. Gynecomastia: Etiology, Diagnosis, and Treatment.; 2000.

Pacyński, A., Budzyńska, A., Przylecki, S.J., & Robaczyński J. [Hyperestrogenism in pharmaceutical factory workers and their children as an occupational disease]. Endokrynol Pol. 1971;22(2):149-154.

Sansone A, Romanelli F, Sansone M, Lenzi A, Di Luigi L. Gynecomastia and hormones. Endocrine. 2017;55(1):37-44. doi:10.1007/s12020-016-0975-9

Kulshreshtha B, Arpita A, Rajesh P, et al. Adolescent gynecomastia is associated with a high incidence of obesity, dysglycemia, and family background of diabetes mellitus. Indian J Endocrinol Metab. 2017;21(1):160. doi:10.4103/2230-8210.196022

Yazici M, Sahin M, Bolu E, et al. Evaluation of breast enlargement in young males and factors associated with gynecomastia and pseudogynecomastia. Ir J Med Sci. 2010;179(4):575-583. doi:10.1007/s11845-009-0345-1

Dundar B, Dundar N, Erci T, Bober E, Büyükgebiz A. Leptin Levels in Boys with Pubertal Gynecomastia. J Pediatr Endocrinol Metab. 2005;18(10). doi:10.1515/JPEM.2005.18.10.929

Dieudonné M-N, Sammari A, Dos Santos E, Leneveu M-C, Giudicelli Y, Pecquery R. Sex steroids and leptin regulate 11β-hydroxysteroid dehydrogenase I and P450 aromatase expressions in human preadipocytes: Sex specificities. J Steroid Biochem Mol Biol. 2006;99(4-5):189-196. doi:10.1016/j.jsbmb.2006.01.007

Eren E, Edgunlu T, Korkmaz HA, et al. Genetic variants of estrogen beta and leptin receptors may cause gynecomastia in adolescent. Gene. 2014;541(2):101-106. doi:10.1016/j.gene.2014.03.013

Catalano S, Mauro L, Marsico S, et al. Leptin Induces, via ERK1/ERK2 Signal, Functional Activation of Estrogen Receptor α in MCF-7 Cells. J Biol Chem. 2004;279(19):19908-19915. doi:10.1074/jbc.M313191200

Fusco R, Galgani M, Procaccini C, et al. Cellular and molecular crosstalk between leptin receptor and estrogen receptor-α in breast cancer: molecular basis for a novel therapeutic setting. Endocr Relat Cancer. 2010;17(2):373-382. doi:10.1677/ERC-09-0340

Lorek M, Tobolska-Lorek D, Kalina-Faska B, Januszek-Trzciakowska A, Gawlik A. Clinical and Biochemical Phenotype of Adolescent Males with Gynecomastia. J Clin Res Pediatr Endocrinol. 2019;11(4):388-394. doi:10.4274/jcrpe.galenos.2019.2019.0027

Monarca C, Rizzo MI. Gynecomastia. Plast Reconstr Surg. 2013;131(5):863e-865e. doi:10.1097/PRS.0b013e318287a18f

Bannayan GA, Hajdu SI. Gynecomastia: Clinicopathologic Study of 351 Cases. Am J Clin Pathol. 1972;57(4):431-437. doi:10.1093/ajcp/57.4.431

Li C-C, Fu J-P, Chang S-C, Chen T-M, Chen S-G. Surgical Treatment of Gynecomastia. Ann Plast Surg. 2012;69(5):510-515. doi:10.1097/SAP.0b013e318222834d

Sollie M. Management of gynecomastia—changes in psychological aspects after surgery—a systematic review. Gland Surg. 2018;7(S1):S70-S76. doi:10.21037/gs.2018.03.09

Ordaz DL, Thompson JK. Gynecomastia and psychological functioning: A review of the literature. Body Image. 2015;15:141-148. doi:10.1016/j.bodyim.2015.08.004

Nuzzi LC, Cerrato FE, Erikson CR, et al. Psychosocial impact of adolescent gynecomastia: A prospective case-control study. Plast Reconstr Surg. 2013;131(4):890-896. doi:10.1097/PRS.0b013e3182818ea8

Kinsella, C., Jr., Landfair, A., Rottgers, S. A., Cray, J. J., Weidman, C., Deleyiannis, F. W. B.,. . .& Losee JE. The psychological burden of idiopathic adolescent gynecomastia. Plast Reconstr Surg. 2012;129(1-7). doi:10. 1097/prs.0b013e3182361efd

March JS, Parker JDA, Sullivan K, Stallings P, Conners CK. The Multidimensional Anxiety Scale for Children (MASC): Factor Structure, Reliability, and Validity. J Am Acad Child Adolesc Psychiatry. 1997;36(4):554-565. doi:10.1097/00004583-199704000-00019

Schonfeld WA. Gynecomastia in Adolescence: Effect on Body Image and Personality Adaptation. Psychosom Med. 1962;24(4):379-389. doi:10.1097/00006842-196200700-00008

Money J, Lewis V. Homosexual/Heterosexual status in boys at puberty: idiopathic adolescent gynecomastia and congenital virilizing adrenocorticism compared☆. Psychoneuroendocrinology. 1982;7(4):339-346. doi:10.1016/0306-4530(82)90037-3

Telegrafo M, Introna T, Coi L, et al. Breast US as primary imaging modality for diagnosing gynecomastia. G di Chir. 2016;37(3):118-122. doi:10.11138/gchir/2016.37.3.118

McArthur JW, Toll GD, Russfield AB, Reiss AM, Quinby WC, Baker WH. Sexual precocity attributable to ectopic gonadotropin secretion by hepatoblastoma. Am J Med. 1973;54(3):390-403. doi:10.1016/0002-9343(73)90034-X

Fauci, Anthony; Kasper, Dennis; Hauser, Stephen; Longo, Dan; Jameson, Larry; Loscalzo J. Harrison- Manuale Di Medicina. XIX 2017. (: Casa Editrice Ambrosiana, ed.).; 2017.

Kanakis GA, Nordkap L, Bang AK, et al. EAA clinical practice guidelines—gynecomastia evaluation and management. Andrology. 2019;7(6):778-793. doi:10.1111/andr.12636

Castro-Magana M, Angulo M, Uy J. Male Hypogonadism with Gynecomastia Caused by Late-Onset Deficiency of Testicular 17-Ketosteroid Reductase. N Engl J Med. 1993;328(18):1297-1301. doi:10.1056/NEJM199305063281802

Pusl T, Stoemmer P. Gynecomastia: Look Beyond the Obvious. Am J Med. 2017;130(10):e439-e440. doi:10.1016/j.amjmed.2017.04.021

Rehman T, Hameed A, Beharry N, Parcq J Du, Bano G. An unusual cause of gynaecomastia in a male. Endocrinol Diabetes Metab Case Reports. 2019;2019. doi:10.1530/EDM-19-0060

Lazala C, Saenger P. Pubertal Gynecomastia. J Pediatr Endocrinol Metab. 2002;15(5). doi:10.1515/JPEM.2002.15.5.553

Malhotra AK, Amed S, Bucevska M, Bush KL, Arneja JS. Do adolescents with gynecomastia require routine evaluation by endocrinology? Plast Reconstr Surg. 2018;142(1):9E-16E. doi:10.1097/PRS.0000000000004465

Diamantopoulos S, Bao Y. Gynecomastia and Premature Thelarche: A Guide for Practitioners. Pediatr Rev. 2007;28(9):e57-e68. doi:10.1542/pir.28-9-e57

Nordt CA, DiVasta AD. Gynecomastia in adolescents. Curr Opin Pediatr. 2008;20(4):375-382. doi:10.1097/MOP.0b013e328306a07c

Osborne CK. Tamoxifen in the Treatment of Breast Cancer. Wood AJJ, ed. N Engl J Med. 1998;339(22):1609-1618. doi:10.1056/NEJM199811263392207

Shahbaz K. Tamoxifen: Pharmacokinetics and Pharmacodynamics. Open Access J Pharm Res. 2017;1(8). doi:10.23880/OAJPR-16000143

Lapid O, van Wingerden JJ, Perlemuter L. Tamoxifen therapy for the management of pubertal gynecomastia: a systematic review. J Pediatr Endocrinol Metab. 2013;26(9-10). doi:10.1515/jpem-2013-0052

Devoto C E, Madariaga A M, Lioi C X, Mardones N. Terapia médica de la ginecomastia con tamoxifeno. Influencia del volumen y duración de la ginecomastia en el resultado terapéutico. Rev Med Chil. 2007;135(12). doi:10.4067/S0034-98872007001200009

Akgül S, Kanbur N, Güçer Ş, Şafak T, Derman O. The histopathological effects of tamoxifen in the treatment of pubertal gynecomastia. J Pediatr Endocrinol Metab. 2012;25(7-8). doi:10.1515/jpem-2012-0105

Derman O, Kanbur N, Kılıç I, Kutluk T. Long-term Follow-up of Tamoxifen Treatment in Adolescents with Gynecomastia. J Pediatr Endocrinol Metab. 2008;21(5). doi:10.1515/JPEM.2008.21.5.449

Chen Y, Jia X, Chen J, Wang J, Hu M. The Pharmacokinetics of Raloxifene and Its Interaction with Apigenin in Rat. Molecules. 2010;15(11):8478-8487. doi:10.3390/molecules15118478

Lawrence SE, Arnold Faught K, Vethamuthu J, Lawson ML. Beneficial effects of raloxifene and tamoxifen in the treatment of pubertal gynecomastia. J Pediatr. 2004;145(1):71-76. doi:10.1016/j.jpeds.2004.03.057

Riepe FG, Baus I, Wiest S, Krone N, Sippell WG, Partsch C-J. Treatment of Pubertal Gynecomastia with the Specific Aromatase Inhibitor Anastrozole. Horm Res Paediatr. 2004;62(3):113-118. doi:10.1159/000079882

Plourde P V., Reiter EO, Jou H-C, et al. Safety and Efficacy of Anastrozole for the Treatment of Pubertal Gynecomastia: A Randomized, Double-Blind, Placebo-Controlled Trial. J Clin Endocrinol Metab. 2004;89(9):4428-4433. doi:10.1210/jc.2004-0082

Beck W, Stubbe P. Endocrinological Studies of the Hypothalamo-Pituitary Gonadal Axis during Danazol Treatment in Pubertal Boys with Marked Gynecomastia. Horm Metab Res. 1982;14(12):653-657. doi:10.1055/s-2007-1019110

Ting, AC; Chow, LW; Leung Y. Comparison of tamoxifen with danazol in the management of idiopathic gynecomastia. Am Surg. 2000;66(1):38-40.

Plourde P V. Clomiphene in the Treatment of Adolescent Gynecomastia. Am J Dis Child. 1983;137(11):1080. doi:10.1001/archpedi.1983.02140370040013

Zachmann M, Eiholzer U, Muritano M, Werder EA, Manella B. Treatment of pubertal gynaecomastia with testolactone. Acta Endocrinol (Copenh). 1986;113(4_Suppl):S218-S226. doi:10.1530/acta.0.112S218

Kasielska-Trojan A, Antoszewski B. Gynecomastia Surgery-Impact on Life Quality: A Prospective Case-Control Study. Ann Plast Surg. 2018;80(2):194. doi:10.1097/SAP.0000000000001173

Fagerlund A, Lewin R, Rufolo G, Elander A, Santanelli di Pompeo F, Selvaggi G. Gynecomastia: A systematic review. J Plast Surg Hand Surg. 2015;49(6):311-318. doi:10.3109/2000656X.2015.1053398

Tu L-C, Tung K-Y, Chen H-C, Huang W-C, Hsiao H-T. Eccentric Mastectomy and Zigzag Periareolar Incision for Gynecomastia. Aesthetic Plast Surg. 2009;33(4):549-554. doi:10.1007/s00266-008-9285-9

Rohrich RJ, Ha RY, Kenkel JM, Adams WP. Classification and Management of Gynecomastia: Defining the Role of Ultrasound-Assisted Liposuction. Plast Reconstr Surg. 2003;111(2):909-923. doi:10.1097/01.PRS.0000042146.40379.25

Abdelrahman I, Steinvall I, Mossaad B, Sjoberg F, Elmasry M. Evaluation of Glandular Liposculpture as a Single Treatment for Grades I and II Gynaecomastia. Aesthetic Plast Surg. 2018;42(5):1222-1230. doi:10.1007/s00266-018-1118-x

Cely AMG, Triana CE, Triana LM. Thorax masculinization in a transsexual patient: Inferior pedicle mastectomy without an inverted T scar. Arch Plast Surg. 2019;46(3):262-266. doi:10.5999/aps.2018.00108

Moon J-E, Ko CW, Yang JD, Lee JS. Combined surgical and medical treatment in an adolescent with severe gynecomastia due to excessive estradiol secretion: a case report. BMC Pediatr. 2019;19(1):515. doi:10.1186/s12887-019-1887-7

Kim DH, Byun IH, Lee WJ, Rah DK, Kim JY, Lee DW. Surgical Management of Gynecomastia: Subcutaneous Mastectomy and Liposuction. Aesthetic Plast Surg. 2016;40(6):877-884. doi:10.1007/s00266-016-0705-y

Yao Y, Yang Y, Liu J, Wang Y, Zhao Y. Vacuum-assisted minimally invasive surgery—An innovative method for the operative treatment of gynecomastia. Surgery. 2019;166(5):934-939. doi:10.1016/j.surg.2019.04.032

Tarallo M, Di Taranto G, Fallico N, Ribuffo D. The round-the-clock technique for correction of gynecomastia. Arch Plast Surg. 2019;46(3):221-227. doi:10.5999/aps.2018.00472

Qutob O, Elahi B, Garimella V, Ihsan N, Drew P. Minimally invasive excision of gynaecomastia – a novel and effective surgical technique. Ann R Coll Surg Engl. 2010;92(3):198-200. doi:10.1308/003588410X12628812458815

Harinatha S. Male Gynecomastia Correction by Superior Dynamic Flap Method: A Consistent and Versatile Technique. World J Plast Surg. 2020;9(1):33-38. doi:10.29252/wjps.9.1.33

Arora Y, Mittal RR, Williams EA, Thaller SR. Barriers to the Effective Management of Gynecomastia in Adolescents. J Craniofac Surg. 2019;30(8):2381-2384. doi:10.1097/SCS.0000000000005999

Murugesan L, Karidis A. External Quilting: New Technique to Avoid Haematoma in Gynaecomastia Surgery. Aesthetic Plast Surg. 2020;44(1):45-51. doi:10.1007/s00266-019-01537-9

Jackson PC, MacInnes EG, Nicholson JK, Brayshaw I, Relton S, Achuthan R. Mastectomy Without Drains Reduces Cost with No Detriment to Patient Outcome. Cureus. 2019;11(7):e5160. doi:10.7759/cureus.5160

Keskin M, Sutcu M, Cigsar B, Karacaoglan N. Necessity of Suction Drains in Gynecomastia Surgery. Aesthetic Surg J. 2014;34(4):538-544. doi:10.1177/1090820X14526598

Chao JW, Raveendran JA, Maly C, Rogers G, Boyajian M, Oh AK. Closed-Suction Drains After Subcutaneous Mastectomy for Gynecomastia: Do They Reduce Complications? Aesthetic Plast Surg. 2017;41(6):1291-1294. doi:10.1007/s00266-017-0959-z

Hansdorfer-Korzon R, Teodorczyk J, Gruszecka A, Lass P. Are compression corsets beneficial for the treatment of breast cancer-related lymphedema? New opportunities in physiotherapy treatment – a preliminary report. Onco Targets Ther. April 2016:2089. doi:10.2147/OTT.S100120

Rosen H, Webb ML, DiVasta AD, et al. Adolescent Gynecomastia. Ann Plast Surg. April 2010:1. doi:10.1097/SAP.0b013e3181dba827

Bembo SA, Carlson HE. Gynecomastia: its features, and when and how to treat it. Cleve Clin J Med. 2004;71(6):511-517. doi:10.3949/ccjm.71.6.511

Al-Allak A, Govindarajulu S, Shere M, Ibrahim N, Sahu AK, Cawthorn SJ. Gynaecomastia: A decade of experience. Surg. 2011;9(5):255-258. doi:10.1016/j.surge.2010.10.004

Dialani V, Baum J, Mehta TS. Sonographic Features of Gynecomastia. J Ultrasound Med. 2010;29(4):539-547. doi:10.7863/jum.2010.29.4.539

Hines SL, Yasrebi M, Tan WW, Perez EA, DePeri ER. The Role of Mammography in Male Patients With Breast Symptoms. Mayo Clin Proc. 2007;82(3):297-300. doi:10.4065/82.3.297

Jones DJ, Holt SD, Surtees P, Davison DJ, Coptcoat MJ. A comparison of danazol and placebo in the treatment of adult idiopathic gynaecomastia: results of a prospective study in 55 patients. Ann R Coll Surg Engl. 1990;72(5):296-298.

Lemaine V, Cayci C, Simmons P, Petty P. Gynecomastia in Adolescent Males. Semin Plast Surg. 2013;27(01):056-061. doi:10.1055/s-0033-1347166

Longheu A, Medas F, Corrias F, et al. Surgical management of gynecomastia: Experience of a general surgery center. G di Chir. 2016;37(4):150-154. doi:10.11138/gchir/2016.37.4.150

Cordova A, Moschella F. Algorithm for clinical evaluation and surgical treatment of gynaecomastia. J Plast Reconstr Aesthetic Surg. 2008;61(1):41-49. doi:10.1016/j.bjps.2007.09.033

Olsson H, Bladstrom A, Alm P. Male gynecomastia and risk for malignant tumours – a cohort study. BMC Cancer. 2002;2(1):26. doi:10.1186/1471-2407-2-26







How to Cite

Pinelli M, De Maria F, Ceccarelli P, Pedrieri B, Bianchini MA, Iughetti L, et al. Gynecomastia: an uncommon, destabilizing condition of the male adolescent. our therapeutic choice. Acta Biomed [Internet]. 2023 Apr. 24 [cited 2024 Jul. 14];94(2):e2023055. Available from: