# A Unique Case of Unilateral Pseudogynecomastia

## TL;DR

A 45-year-old mechanic developed unilateral breast enlargement due to fat accumulation, not glandular growth, and was successfully treated with surgery.

## Contribution

This case highlights a rare occupational cause of unilateral pseudogynecomastia and the effectiveness of the Kornstein surgical technique.

## Key findings

- Unilateral enlargement was caused by lipomatosis and fibrous tissue without glandular involvement.
- Surgical excision using the Kornstein technique preserved the nipple–areola complex and achieved good cosmetic results.
- Histopathology confirmed no malignancy and no recurrence after 12 months.

## Abstract

Background/Objectives: Gynecomastia is a common condition characterized by the benign enlargement of male breast tissue, often resulting from hormonal imbalances. A rare variant, unilateral pseudogynecomastia, involves enlargement due to adipose tissue accumulation without glandular proliferation and can be associated with occupational factors. Methods: We report the case of a 45-year-old male mechanic presenting with unilateral enlargement of the left breast. The patient reported daily microtrauma on his left axilla and chest wall. The clinical evaluation and imaging revealed lipomatosis with pronounced fibrous tissue and no glandular tissue involvement. The hormonal assays were within the normal limits. The patient underwent surgical excision of excess adipose tissue using the Kornstein technique, preserving the nipple–areola complex. Results: The histopathological examination confirmed the absence of malignancy. The postoperative recovery was uneventful, and the follow-up examination at 12 months demonstrated a symmetrical breast appearance with no recurrence. This case underscores the importance of differentiating pseudogynecomastia from true gynecomastia and recognizing potential occupational risks. Surgical management using techniques that preserve the nipple–areola complex can achieve excellent cosmetic outcomes.