Gynecomastia (GM) is a benign condition involving glandular proliferation within male breast tissue. Atypical ductal hyperplasia (ADH) is considered a high-risk lesion due to its association with an increased risk of breast cancer; however, the literature remains sparse regarding the male population with underlying ADH. ADH in the setting of GM. Currently, the reported incidence of ADH with GM ranges from 0.4% to 4.5%. Here, we present a case of a male patient with recurrent ADH after a previous excision for bilateral ADH that was upstaged to ductal carcinoma in situ (DCIS) after definitive surgery for the recurrent ADH. The ADH and DCIS were successfully excised via central lumpectomy. A brief literature review on its incidence and treatment within the male population was also conducted. This case highlights the rarity of ADH and DCIS in men, as well as their recurrence following nipple-sparing mastectomy.

Androgenetic alopecia (AGA) is the most common cause of non-scarring hair loss in men. Although topical minoxidil and oral finasteride are established treatments, some patients show limited clinical response despite prolonged therapy. Evidence on the use of oral bicalutamide in male AGA remains scarce because of concerns about systemic adverse effects. We report the case of a 45-year-old man with treatment-resistant AGA who experienced clinically apparent hair regrowth during oral bicalutamide exposure after an inadequate response to conventional therapies. Treatment was accompanied by gynecomastia, mastodynia, decreased libido, erectile dysfunction, and mild elevations in hepatic enzymes, leading to drug discontinuation. Clinical adverse effects resolved after withdrawal of bicalutamide; however, follow-up hormonal evaluation and liver function tests were unavailable. This case describes a temporal association between androgen receptor blockade, clinically apparent hair regrowth, and clinically significant adverse effects. Although the findings provide additional insight into the role of androgen receptor signaling in AGA, they should not be interpreted as evidence supporting the use of oral bicalutamide in male patients. Further controlled studies are needed to better define the safety profile and potential role of androgen receptor antagonism in androgenetic alopecia.

We present the case of primary testicular diffuse large B-cell lymphoma diagnosed at the stage of pectoral skin metastasis in a 40-year-old male patient. He presented with a painless mass in the left scrotum that was complicated by ulcerated gynecomastia. An orchiectomy combined with a pectoral tumorectomy led to this diagnosis. The tumor was of the non-centro-germinative B subtype and classified as pT3NxM1b, Ann-Arbor stage IV E. The patient died while undergoing chemotherapy. This case underscores the poor prognosis associated with this histological type and the value of immunohistochemistry in diagnosis.

Background/Objectives: Breast fibromatosis (desmoid-type fibromatosis) is a rare, locally aggressive neoplasm that may closely mimic breast carcinoma on imaging. Occurrence in male patients is exceptionally uncommon, particularly in association with gynecomastia. We report a rare case of male breast fibromatosis and discuss the diagnostic challenges, surgical decision-making, and reconstructive management. Methods: A 35-year-old male presented with a palpable right breast mass and bilateral grade II gynecomastia. Histopathological and immunohistochemical analyses were performed. Following multidisciplinary evaluation, the patient underwent wide local excision of the lesion with immediate glandular-adipose tissue rearrangement and simultaneous contralateral gynecomastia correction. Results: Ultrasonography demonstrated a hypoechoic lesion of 12 × 11 mm, whereas mammography revealed an irregular mass measuring up to 34 mm. Core needle biopsy showed a fibroblast-rich spindle-cell proliferation with nuclear β-catenin positivity, consistent with desmoid-type fibromatosis. Final histopathology confirmed a 2.5 cm lesion with negative resection margins (minimum margin 5 mm). Immediate reconstruction achieved a satisfactory chest contour and symmetry. No evidence of recurrence was observed during 18 months of follow-up. Conclusions: Breast fibromatosis should be considered in the differential diagnosis of suspicious male breast lesions because radiological findings may closely resemble breast carcinoma. Histopathological confirmation remains essential for appropriate management. In selected patients, immediate glandular-adipose tissue rearrangement may facilitate single-stage defect reconstruction and preservation of chest contour following oncologic excision.

Breast schwannomas are rare benign tumors originating from Schwann cells of peripheral nerves. They are exceedingly uncommon in the male breast and are often misdiagnosed as gynecomastia, particularly in patients on prolactin-elevating medications. We report a case of a 40-year-old male with a longstanding palpable mass in the upper outer quadrant of the left chest wall. The patient had a history of schizoaffective disorder and was on antipsychotic therapy, initially leading to the clinical presumption of gynecomastia. Diagnostic mammography revealed a well-circumscribed, noncalcified mass adjacent to the pectoralis muscle. Ultrasound demonstrated a heterogeneously hypoechoic lesion with cystic changes, classified as BI-RADS 4. Ultrasound-guided core biopsy revealed a schwannoma with S100 positivity which was confirmed on final surgical pathology after excision. This case underscores the importance of maintaining a broad differential for male breast masses and highlights the limitations of imaging alone in distinguishing rare benign neoplasms from malignancy. Biopsy remains essential for diagnosis, particularly in patients with confounding clinical risk factors.