Fibroadenoma with gynecomastia in young male: a case report

Breast fibroadenoma is a common benign tumor in females, yet its occurrence in males is exceedingly rare, with limited clinical documentation. This case is reported due to its rarity and the atypical imaging features it presented, which warranted clinical attention. A 29-year-old Chinese male presented with gynecomastia and mild abnormalities in sex hormone levels, with no family history of breast cancer or history of relevant medication use. Preoperative ultrasound and MRI of the left breast revealed an irregularly shaped, poorly defined mass (assessed as BI-RADS 4A), raising concern for a neoplastic process. The patient underwent an excisional biopsy, and the histopathological examination confirmed the diagnosis of a fibroadenoma associated with focal gynecomastia and areas of active ductal epithelial hyperplasia. The patient's clinical management timeline is summarized in Table 1. This case underscores that fibroadenoma should be considered in the differential diagnosis for male breast lesions, even when associated with gynecomastia or when imaging features are atypical and suggest malignancy. Recognizing this possibility is crucial, and definitive histopathological evaluation remains essential to guide appropriate clinical management.