Big Cat said:
Feel free to point me in the general direction of these 'documented cases'.
Estrogen and progesterone receptors in gynecomastia.
Pensler JM, Silverman BL, Sanghavi J, Goolsby C, Speck G, Brizio-Molteni L, Molteni A.
Division of Plastic Surgery, Children's Memorial Hospital, Chicago, Ill., USA.
[email protected]
The etiology of gynecomastia is unknown. There seems to be no increased incidence of malignancies in patients with idiopathic gynecomastia; however, patients with Klinefelter syndrome exhibit an increased incidence of malignancy. The authors reviewed the results of 34 patients with gynecomastia diagnosed in adolescence who, following initial evaluation, had a mastectomy. The estrogen and progesterone receptors were analyzed in these patients. Three of the patients were diagnosed with Klinefelter syndrome. These three patients exhibited elevated amounts of estrogen and progesterone receptors. None of the patients who were not diagnosed with this syndrome demonstrated significant elevation of their estrogen or progesterone receptors. The presence of elevated estrogen and progesterone receptors in patients with Klinefelter syndrome provides a potential mechanism by which these patients may develop breast neoplasms. The absence of elevated estrogen and progesterone receptors in patients with idiopathic gynecomastia may serve to clarify why these patients' disease rarely degenerates into malignancy.
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Aromatase and steroid receptors in gynecomastia and male breast carcinoma: an immunohistochemical study.
Sasano H, Kimura M, Shizawa S, Kimura N, Nagura H.
Department of Pathology, Tohoku University School of Medicine, Sendai, Japan.
Hormonal factors have been implicated in the development of male breast disorders, including carcinoma and gynecomastia. We studied the expression of aromatase and estrogen (ER), progesterone (PR), and androgen (AR) receptors by immunohistochemistry in male breast carcinoma (15 cases) and gynecomastia (30 cases) to evaluate their possible significance in these disorders. Relatively strong aromatase immunoreactivity was observed in all cases of carcinoma, but in only 11 of 30 cases (37%) of gynecomastia. ER and PR expression was observed in the nuclei of ductal cells in all the cases of gynecomastia. More than 10% of the carcinoma cells were positive for ER and PR in 9 of 15 (60%) and 10 of 15 (67%) carcinomas, respectively. AR immunoreactivity was observed in nuclei of both epithelial and non-epithelial cells. AR was present in ductal or carcinoma cells in 13 of 15 (87%) cases of carcinoma and in all 30 (100%) cases of gynecomastia. The mean percentage of ER-, PR-, and AR-positive cells were significantly higher in gynecomastia than in carcinoma. There was a close association of AR with ER (P < 0.01) and PR (P < 0.01) in cases of gynecomastia, but there was a significant inverse correlation between AR and ER (P < 0.01) or PR (P < 0.05) expression in carcinoma cases. Increased aromatase expression in the stromal cells is considered to contribute to the increment in the in situ estrogen concentration and the development of male breast carcinoma.
PMID: 8768875 [PubMed - indexed for MEDLINE]
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Treatment of unresectable meningiomas with the antiprogesterone agent mifepristone.
Grunberg SM, Weiss MH, Spitz IM, Ahmadi J, Sadun A, Russell CA, Lucci L, Stevenson LL.
Department of Neurosurgery, University of Southern California School of Medicine, Los Angeles.
The possibility that meningioma growth may be related to female sex hormone levels is suggested by several lines of evidence. Meningiomas are twice as common in women as in men, have been observed to wax and wane with pregnancy, and are positively associated with breast cancer. A physiological explanation for these phenomena is provided by the finding of steroid hormone receptors in meningiomas. However, unlike breast cancer, meningiomas are much more commonly positive for progesterone receptors than for estrogen receptors. The authors initiated a study on long-term oral therapy of unresectable meningiomas with the antiprogesterone mifepristone (RU486). Fourteen patients received mifepristone in daily doses of 200 mg for periods ranging from 2 to 31+ months (greater than or equal to 6 months in 12 patients). Five patients have shown signs of objective response (reduced tumor measurement on computerized tomography scan or magnetic resonance image, or improved visual field examination). Three have also experienced subjective improvement (improved extraocular muscle function or relief from headache). The side effects of long-term mifepristone therapy have been mild. Fatigue was noted in 11 of the 14 patients. Other side effects included hot flashes in five patients, gynecomastia in three, partial alopecia in two, and cessation of menses in two. Long-term therapy with mifepristone is a new therapeutic option that may have efficacy in cases of unresectable benign meningioma.
PMID: 2033444 [PubMed - indexed for MEDLINE]
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High serum progesterone in hyperthyroid men with Graves' disease.
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Department of Medicine, Tokyo Women's Medical College, Japan.
We measured serum progesterone in five men with hyperthyroidism due to Graves' disease. All had elevated serum progesterone levels before treatment with an antithyroid drug, and their serum progesterone levels declined concomitantly with their serum thyroid levels during treatment. Progesterone enhances estrogen's stimulation of mammary gland growth, and our findings suggest that progesterone may play a role in the gynecomastia that occurs in men with hyperthyroidism.
PMID: 3335607 [PubMed - indexed for MEDLINE]
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Estrogen and progesterone receptors in human breast cancer. Correlation with histologic subtype and degree of differentiation.
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Microscopic review of 490 consecutive human breast biopsy and mastectomy specimens were correlated with estrogen and progesterone receptor content of the tissue, by subtype and degree of differentiation. Of the 4 grades of differentiation, the less differentiated Grade III and IV tumors showed significantly lower levels of estrogen and progesterone receptors in infiltrating ductal and lobular carcinoma (P less than 0.001). In contrast, patients with medullary carcinoma had the lowest tissue levels of estrogen and progesterone receptors with approximately 80% of the cases with less than 10 fmol/mg protein. Patients with mucinous carcinoma had the highest percentages of positive estrogen and progesterone receptor levels (75% and 87%, respectively). Sixty-three percent of the patients with Grade IV infiltrating ductal carcinoma were younger than 53 years of age (P less than 0.001). Patients younger than 53 years of age with Grade II and III infiltrating ductal carcinoma also had significantly lower levels of estrogen receptors, but not of progesterone receptors, than those patients older than 53 years of age (P less than 0.001). Nineteen of 20 "normal" breast tissue specimens were negative (less than 3 fmol/mg protein) for estrogen and progesterone receptors. About 50% of 17 tissue specimens from benign breast lesions (fibroadenoma, fibrocystic disease, sclerosing adenosis) showed positive estrogen (greater than 10 fmol/mg protein) or progesterone receptor values. In two patients with gynecomastia, no estrogen or progesterone receptors were detectable.
PMID: 3015374 [PubMed - indexed for MEDLINE]
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