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MMLU / A 14-year-old boy is brought to the physician for a physical examination prior…

Problem

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question

A 14-year-old boy is brought to the physician for a physical examination prior to participating in sports. He appears reluctant to remove his shirt for the examination, and says that he is embarrassed because he has grown breasts during the past year. He is at the 50th percentile for height and weight. Physical examination shows bilateral 1.5-cm fibroglandular masses located beneath the nipple-areolar complex and normal penis and testes. Pubic hair development is Tanner stage 3. Serum concentrations of gonadotropic hormones, estrogens, and testosterone are within the reference ranges. Which of the following is the most likely cause of this patient's breast enlargement?

choices

  1. Estradiol-secreting Leydig cell tumor
  2. Peutz-Jeghers syndrome
  3. Seminiferous tubule dysgenesis (Klinefelter syndrome)
  4. Normal development

subject

professional_medicine

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