Gynecomastia, an excessive development of the mammary glands in men, is a known phenomenon among patients with traumatic spinal cord injury, yet in the last 50 years possible pathophysiology for the same has not been fully elucidated. A clinical examination for the presence of gynecomastia should be performed in every patient with traumatic spinal cord injury and a thorough endocrinological and malignancy workup should follow that. Most of the time, the workup for malignancy turns out to be negative which is reassuring to an anxious patient undergoing a disruption of his body image. Here we present an incidental finding of bilateral gynecomastia in a post traumatic quadriplegic patient admitted in medicine ward.

1. Heruti RJ, Dankner R, Berezin M, Zeilig G Ohry A. Gynecomastia following spinal cord disorder. Arch Phys Med Rehabil 1997;78:534-7.
2. Cooper IS, MacCarty CS, Rynearson EH. Gynecomastia in paraplegic males. J Neurosurg. 1950 Jul;7(4):364-7.
3. Freeman L.W. The metabolism of calcium in patients with spinal cord injuries.Ann Surg,1949,129:177-184.
4. Naftchi N. Alterations of neuroendocrine functions in spinal cord injury.Peptides vol6,1985, 85-94.
5. Claus-Walker J, Halstead LS. Metabolic and endocrine changes in spinal cord injury: The nervous system before and after transaction of the spinal cord. Arch Phys Med Rehabil 1981;62:595-601.
6. Herman JP, McKlveen JM, Ghosal S, et al. Regulation of the Hypothalamic-Pituitary-Adrenocortical Stress Response. Compr Physiol. 2016;6(2):603–621.
7. Cortes-Gallegos V, Castaneda G, Alonso R. Pituitary-testis relationship in paraplegic men. J Antral 1981;2:326-30.
8. Braunstein, Glenn D. Current Concepts: Gynecomastia. N Engl J Med 1993;328:490-5.
9. Swerdloff RS, Ng JCM. Gynecomastia: Etiology, Diagnosis, and Treatment. 2015,656-657.

Sandra Mosses

Junior Resident, Department of General Medicine, Govt.T.D Medical College, Alappuzha, Kerala, India-688005