Abstract
Summary and Conclusions
1. We have studied 8 patients with hepatic cirrhosis in whom gynecomastia occurred late in the disease, confirming the findings of Silvestrini, Corda and others. 2. In all of these cases bilateral gynecomastia was preceded by the development of ascites. 3. The histological changes in these hyperplastic mammae are similar to the changes seen in experimental estrone stimulation (growth of ducts). 4. Sevringhaus, Israel, et al., have shown experimentally that the liver normally plays a role in the inactivation or destruction of estrogen. Accordingly, it is reasonable to suspect that organic liver disease may result in abnormalities in estrogen metabolism. The increased urinary excretion of total estrogen in 2 cases and of free estrogen in 2 cases tends to justify this assumption. 5. An explanation of the absence of gynecomastia in acute hepatic necrosis and in the majority of cases of cirrhosis is not as yet apparent. The effect of testicular atrophy upon androgen excretion also is not clear.
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