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In obese men presenting with gynecomastia, elevated estrogens, and hypogonadism, what clinical factors would push you to obtain testicular and/or adrenal imaging to rule out an estrogen-producing tumor?
Do you base the decision off of the acuity and course of symptoms? The degree of estradiol elevation? Other factors?
Answer from: at Academic Institution
It is not generally necessary or useful to measure serum estradiol in the evaluation of acute (tender and/or growing) gynecomastia. The widely available estradiol assays are generally immunoassays that are not accurate at the low estradiol concentrations in men. In addition, it is not uncommon to se...
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