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Findings of Gynecomastia That Developed in Follow-up Secondary to Bicalutamide Treatment on Bone Scan

10.4274/mirt.galenos.2019.50490

• Kemal Ünal
• Nahide Gökçora

Received Date: 28.09.2018 Accepted Date: 01.10.2019 Mol Imaging Radionucl Ther 2020;29(2):82-84 PMID: 32368880

• Abstract
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Prostate cancer is a common neoplastic disease especially in elder patients. Metastatic prostate disease has low five-year survival rate. Bicalutamide is an androgen receptor antagonist that acts as an inhibitor by competizing androgen receptors in the target tissue and used as a treatment option in prostate cancer. Bone scan was performed on a 79-year-old male with prostate cancer in our department. Blood pool images showed bilateral hyperemia in the breast regions which was not present on the previous scan one year ago. On physical examination, there was bilateral painful gynecomastia. It was learned that the patient was given Bicalutamide therapy after the first bone scan. Blood pool images may detect this side effect and should be evaluated with physical examination in case of clinical doubt.

Keywords: Bicalutamide, gynecomastia, bone scan, prostate cancer

Ethics

Informed Consent: Written informed consent of the patient was obtained from patient.

Peer-review: Externally and internally peer-reviewed.

Authorship Contributions

Surgical and Medical Practices: K.Ü., Concept: K.Ü., Design: K.Ü., Data Collection or Processing: K.Ü., N.G., Analysis or Interpretation: K.Ü., N.G., Literature Search: K.Ü., Writing: K.Ü.

Conflict of Interest: No conflict of interest was declared by the authors.

Financial Disclosure: The authors declared that this study received no financial support.

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1. Akaza H. Combined androgen blockade for prostate cancer: review of efficacy, safety and cost-effectiveness. Cancer Sci 2011;102:51-56.
2. Iversen P, Melezinek I, Schmidt A. Nonsteroidal antiandrogens: a therapeutic option for patients with advanced prostate cancer who wish to retain sexual interest and function. BJU Int 2001;87:47-56.
3. Fagerlund A, Cormio L, Palangi L, Lewin R, Santanelli di Pompeo F, Elander A, Selvaggi G. Gynecomastia in Patients with Prostate Cancer: A Systematic Review. PLoS One 2015;10:e0136094.
4. Sieber PR. Treatment of bicalutamide-induced breast events. Expert Rev Anticancer Ther 2007;7:1773-1779.
5. Braunstein GD. Aromatase and gynecomastia. Endocr Relat Cancer 1999;6:315-324.
6. Kothekar E, Raynor WY, Al-Zaghal A, Werner TJ, Alavi A. Incidental 18F-NaF Uptake in Drug-Induced Gynecomastia. Clin Nucl Med 2019;44:303-304.
7. Farag AA, Andrikopoulou E, Hage FG. Spironolactone-induced bilateral gynecomastia in a man detected by SPECT myocardial perfusion imaging. J Nucl Cardiol 2017;24:742.
8. Wang HY, Jeng LB, Lin MC, Chao CH, Lin WY, Kao CH. 18F-FDG PET/CT in detection of gynecomastia in patients with hepatocellular carcinoma. Clin Imaging 2013;37:942-946.