A 38- year-old male comes to the office because of a recent scroutm enlargement. He also states that he does not like to have sex anymore. The patient has no chronic medical conditions and takes no medication. Physical examination is notable for significant enlargement of the left testis and bilateral gynecomastia. His other secondary sexual characteristics are normal. Serum B-hCG is markedly elevated and serum TSH is normal. Scrotal ultrasound reveals a 2.8-cm, irregular testicular mass with cystic areas. Which of the following is the most likely cuse of this patient's gynecomastia?

Question

A 38- year-old male comes to the office because of a recent scroutm enlargement. He also states that he does not like to have sex anymore. The patient has no chronic medical conditions and takes no medication. Physical examination is notable for significant enlargement of the left testis and bilateral gynecomastia.  His other secondary sexual characteristics are normal.  Serum B-hCG is markedly elevated and serum TSH is normal.  Scrotal ultrasound reveals a 2.8-cm, irregular testicular mass with cystic areas.  Which of the following is the most likely cuse of this patient's gynecomastia?

Quizplus · Accepted Answer

Eductional Objective: Increase estrogen/ androgen ratio due to impairs testosterone production in Leydig cells while increasing aromatase activity and conversion of androgens to estrogens because of a secreation of hCG by testicular germ cell tumors

A 38- Year-Old Male Comes to the Office Because of a Recent