Sonographic Appearance of Gynecomastia Among Patients in University College Hospital (UCH), Ibadan: A Retrospective Review

Abstract

Purpose: Gynecomastia, a benign proliferation of male breast glandular tissue, is a common condition affecting males across all ages and body types. This study aimed to review the demographic profile, clinical presentation, and sonographic characteristics of gynecomastia cases scanned at the Ultrasound suite of the Radiology Department, University College Hospital (UCH), Ibadan, and to provide data on sonographic characteristics and patterns of presentation in this population.

Methods: A retrospective review of all sonographically imaged cases of gynecomastia at UCH over 2 years was conducted. Clinical and demographic data, including age, BMI, marital status, breast laterality, prior breast disease, and histological subtype, were extracted from records. Data was analyzed in SPSS v27; frequencies and means were reported, and associations between categorical variables were assessed using the χ² test, with p ≤ 0.05 considered significant.

Results: A total of 30 male patients were included (mean age 37.4 years, range 8–79); 50% were >30 years, 26.7% were 18–30, and 23.3% <18. Mean BMI was 23.8 kg/m², with most patients in the normal range (43.3%), followed by overweight (26.7%), obese (16.7%), and underweight (13.3%). Marital status was evenly split, and over half had higher education. Most had no prior breast disease (86.7%), and nearly half presented subacutely (46.7%). Clinically, gynecomastia was diagnosed in 96.7%, mostly painless (83.3%) and bilateral (50%). Ultrasound confirmed gynecomastia in 76.7%, showing strong concordance with clinical diagnosis (χ² = 30.0, p < 0.001); unilateral cases predominated on ultrasound (60.9%). Among the 23 patients with gynecomastia, the dendritic pattern was most frequent (47.8%), followed by nodular (39.1%) and diffuse glandular types (13%). There were no statistically significant associations between gynecomastia pattern and age (χ² = 2.254, p = 0.689) or body mass index (χ² = 5.045, p = 0.538).

Conclusion: Gynecomastia in this cohort commonly presented as true glandular enlargement across diverse ages and body types, with clinical examination demonstrating high reliability and ultrasound providing valuable confirmation and tissue characterization. Gynecomastia classification showed no significant association with age or body mass index, highlighting the limited predictive value of demographic and anthropometric factors.