skip to main content

Pubertal gynaecomastia — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

EasyEndocrinePubertal gynaecomastiaRACP Paediatrics

A 13-year-old boy is distressed by bilateral firm breast tissue behind the areolae (4 cm diameter). He is in Tanner stage 3 puberty with normal testicular volumes. Investigations show normal LH, FSH, testosterone, oestradiol, and liver function. What is the most likely diagnosis?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: D — Physiological (pubertal) gynaecomastia

Bilateral gynaecomastia during mid-puberty (Tanner 3-4, age 12-14) in a boy with normal hormones and testicular volumes is physiological pubertal gynaecomastia. It affects up to 65% of boys and typically resolves within 1-3 years. Reassurance is the mainstay. Investigation is only needed if there are atypical features (unilateral, rapid growth, small testes, abnormal hormones).

Reference: RCH Melbourne – 2023 – Gynaecomastia CPG; RACP Paediatric Curriculum – Endocrine