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Abstract:

Gynaecomastia as presenting symptom in a patient with lung cancer The medical history of a 66-year-old male exsmoker diagnosed with non-small-cell lung cancer after developing painful unilateral gynaecomastia is presented. Large-cell lung carcinoma can be associated with marked elevations of serum hCG, causing gynaecomastia due to an imbalance between the stimulatory effect of estrogens and the inhibitory effect of androgens. In adult patients seeking help for gynaecomastia, one should consider lung malignancies as a possible etiology. Furthermore, attention is drawn to the possible false-positive results of a fluorodeoxyglucose (FDG)-PET scan after immunization. Influenza vaccination may cause lymphatic activation and result in FDG uptake in the draining axillary lymph nodes close to the vaccination site. The highest FDG uptake is seen in patients vaccinated five to twelve days before the FDG-PET examination. Hence, knowledge of the vaccination history is crucial. Otherwise, FDG uptake in reactive axillary lymph nodes could be considered as an expression of disseminated oncologic disease.