The Male Breast. M.Sklair -Levy, M.D Radiology Department Sheba Medical Center Israel. The Male Breast . Clinical symptoms Unilateral, bilateral breast enlargement Breast pain Breast lump Most of the evaluated lesions are benign Most related to gynecomastia. Introduction .
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Sheba Medical Center
Remnant of subareolar ductal tissue
Lobular development - which requires both estrogen and progesterone, is usually not observed in menNormal Male Breast
Anatomy of the normal male breast- consists of the skin and subcutaneous fat. The pectoralis fascia (PF), pectoralis muscle (PM), ribs,and intercostal muscles (ICM)
Chronic renal insufficiency
Exogenouis estrogenCauses of Gynecomastia
Nodular subareolar density
Hypervascular flow within the mass
subareolar, fanshaped,hypoechoic nodule surrounded by echogenic normal fatty tissue
Dendritic subareolar density with posterior linear projections radiating into the surrounding tissue
US- subareolar hypoechoic nodule with star-shaped projections into the surrounding echogenic fibrous tissue
Enlargement of the breast and diffuse density with both dendritic and nodular features
Heterogeneous breast with both nodular and dendritic projections surrounded by diffuse hyperechoic fibrous tissue.
Parallel, homogeneous, mildly hyperechoic mass with a capsule (arrow) under the skin.
Subtle encapsulated fatty mass (arrows) in the palpated region.
Hypoechoic lesion, which is contiguous to the epidermis (arrows) (the “claw sign”) with increased through transmission
well defined, dense, oval mass contiguous to the skin in the palpated region.
Solid hyperechoic mass with posterior acoustic shadowing
Dense circumscribed mass
US-multiple eccentric, subareolar, elongated,well-defined, hypoechoic masses ;US image shows cystic areas, which may
represent associated ductal ectasia.
discrete dense mass against a background of subareolar density, which consistent with gynecomastia