Computed Tomography Findings Associated With Gynecomastia In The Adolescent Males

INTRODUCTION: We aimed to investigate the prevalence, imaging findings and possible related factors of incidental gynecomastia on non-contrast computed tomography (CT) in adolescent males. METHODS: 103 non-contrast thoracic CT scans taken between the ages of 13-18 in terms of traffic accident, suspected COVID-19 or chest wall anomaly, were evaluated retrospectively. Liver and spleen parenchyma density proportioned to each other, and those below the value of 0.8 were evaluated as hepatosteatosis (HS). Retroareolar glandular tissue above 2 cm cut-off were determined as gynecomastia. Adipose tissue thickness(ATT) was evaluated at 3 levels: subareolar subcutaneus tissue(S-ATT); abdominal subcutaneus tissue(A-ATT), and the distance between the kidney posterior and fascia(I-ATT) was measured. Statistical analysis was performed using IBM SPSS version 25.0. RESULTS: 20 of 103 cases had gynecomastia and 7 cases had HS. No significant correlation was found between gynecomastia and HS (p=0.843). There was a statistically significant relationship between gynecomastia and I-ATT(p=0.03); HS vs A-ATT(p=0.029), S-ATT (p=0.01), A-ATT (p=0.023) and S-ATT(p=0.034). According to Pearson's correlation analysis, there was a weak correlation between gynecomastia and S-ATT (r=0.321, p=0.001), and between I-ATT (r=0.353; p=0.001); moderate correlation between S-ATT and A-ATT (r=0.508, p<0.001); strong correlation between A-ATT and S-ATT (r=0.892, p0.001). DISCUSSION AND CONCLUSION: We showed that the amount of S-ATT, A-ATT and I-ATT are factors that may be associated with gynecomastia. The reason for this relationship may be the increase in estradiol caused by aromatase that released from subcutaneous and intra-abdominal adipose tissue. In cases with gynecomastia in the adolescent group, visceral increased adiposity may also be considered in clinical practice.