INVESTIGATIONS
At presentation (06/04/2023) his laboratory work up comprised general haematology, biochemistry and endocrinology panels (thyroid stimulating hormone, free testosterone, cortisol, luteinising hormone, estradiol, progesterone, sex hormone binding globulin, testosterone, follicle-stimulating hormone levels and cancer antigen 15-3 level) were all within the normal range with exception of a low estimated GFR CKD EPI (glomerular filtration rate chronic kidney disease epidemiology collaboration) 72ml/min/1.73m2 with a normal range serum creatinine. One week later (on 13/04/2023), he was booked into the breast clinic for further evaluations. An ultrasound scan was performed by a consultant radiologist and it showed a large amount of glandular looking breast tissue, with no signs of malignancy on the left side. On the right side, there was no convincing glandular breast tissue and no signs of malignancy either. A mammogram was also performed and showed a small amount of glandular looking tissue slightly more on the left side than the right side with no signs of malignancy on both sides. This appearance is consistent with bilateral asymmetrical true gynecomastia. His follow up biochemistry laboratory tests at the great clinic were also within normal range, with exception of a low Estimated GFR CKD EPI 80ml/min/1.73m2 (normal range serum creatinine). And a month later (05/05/2023), a control of his endocrinology panel was repeated and results were still within normal range. A testicular sonogram was performed and revealed a reducible left inguinal hernia containing peritoneal content. His last (26/06/2023) biochemistry work up remains within normal range.