What is the most likely cause of his gynecomastia?

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What is the most likely cause of his gynecomastia?

What is the most likely cause of his gynecomastia?
What is the most likely cause of his gynecomastia?

A 14-year-old junior high school student is brought in by his mother and father because he seems to be developing breasts.

The mother is upset because she read on the Internet that smoking marijuana leads to breast enlargement in males. The young man adamantly denies using any tobacco, alcohol, or drugs. He has recently noticed changes in his penis, testicles, and pubic hair pattern. Otherwise, his past medical history is unremarkable. His parents are both in good health. He has two older brothers who never had this problem. On examination, you see a mildly overweight teenager with enlarged breast tissue that is slightly tender on both sides. Otherwise, his examination is normal. He is agreeable to taking a drug test. What is the most likely cause of his gynecomastia?

Breast cancer

Imbalance of hormones of puberty

Drug use