When assessing a patient with gynecomastia, what condition should also be evaluated?

In the assessment of a patient with gynecomastia, it is essential to evaluate for testicular cancer as it can be associated with the development of breast tissue in males. Gynecomastia can sometimes be a manifestation of underlying malignancies that disrupt hormonal balance, including testicular tumors, which might secrete hormones or hormone-like substances that lead to breast tissue growth.

Testicular cancer, particularly germ cell tumors, can produce elevated levels of human chorionic gonadotropin (hCG) or other hormones that induce gynecomastia. Thus, a thorough evaluation often includes a physical examination of the testes and possibly imaging studies to rule out any neoplastic conditions.

While conditions like obesity and endocrine abnormalities are also relevant in the differential diagnosis of gynecomastia, they are not directly linked to malignancy as specifically as testicular cancer. Tuberculosis generally does not have a direct relationship with gynecomastia and is rarely considered in this context. Thus, focusing on potential malignancies like testicular cancer is paramount in the evaluation process.