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Practice Lesson of the week

Testicular tumour presenting as gynaecomastia

BMJ 2006; 332 doi: (Published 06 April 2006) Cite this as: BMJ 2006;332:837
  1. Maya Harris, staff grade urologist (,
  2. Syed Rizvi, associate specialist in urology1,
  3. John Hindmarsh, consultant urological surgeon1,
  4. Rob Bryan, consultant breast surgeon2
  1. 1 Urology Department, Friarage Hospital, Northallerton DL6 1JG
  2. 2 General Surgery Department, Friarage Hospital
  1. Correspondence to: M Harris
  • Accepted 24 December 2005

The association of gynaecomastia and testicular tumours is well described in the literature. A testicular examination should be routine as part of the assessment of young males presenting with breast enlargement. We describe two cases where gynaecomastia preceded the appearance of testicular swelling by several months.

Case reports

Case 1

A 27 year old man was routinely referred to a general surgery department and assessed by a breast surgeon (RB) for bilateral gynaecomastia. On examination, the testes were normal.

Six months later he was referred to the urology department with a history of persistent terminal haematuria. The patient mentioned during the examination that he had discovered a lump in a testicle since his attendance at the breast clinic. He had paid no attention to it and had not complained about it to his general …

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