Possibly something for Megazoid;
http://pmj.bmj.com/cgi/content/full/75/882/229
Gynaecomastia as a presenting feature of thyrotoxicosis
bilateral hydroceles
right testis to be diminished in size and there was marked lymphoedema of the left leg.
In our two patients, case 2 had a typical `thyrotoxic' sex hormone profile with raised SHBG, and total testosterone at the time of presentation. However, subclinical hypogonadism was also documented before presentation of thyrotoxicosis. The hormonal profile in case 1 (low testosterone, impaired FSH and LH response to LHRH, and normal SHBG) is consistent with hyperprolactinaemia. However, the fact that gynaecomastia (but not galactorrhoea) subsided after control of thyrotoxicosis, but before commencement of bromocriptine, further supports the suggestion that thyrotoxicosis was responsible for the gynaecomastia. Both cases showed resolution of gynaecomastia after reversal of thyrotoxicosis. These two cases share one common feature, namely the presence of an additional insult apart from thyrotoxicosis. In case 1, hyperprolactinaemia causing hypogonadotrophic hypogonadism, was a major factor with superimposed (relatively mild) thyrotoxicosis precipitating the clinical presentation. In case 2, the underlying pathology was (relatively mild) subclinical gonadal failure but the thyrotoxicosis was more severe.