Bilateral lipomastia in men: a side effect of highly active antiretroviral therapy.

Breast enlargement in men and women is a documented feature of the highly active antiretroviral therapy- associated human immunodeficiency virus lipodystrophy syndrome. The exact underlying histomorphological features of this condition are speculative because most cases are diagnosed on clinical grounds with or without radiographic confirmation. The main documented causes of breast enlargement in men on highly active antiretroviral therapy include gynecomastia and lipomastia; however, biopsy-confirmed lipomastia is a rarely described phenomenon, with only 1 such case being described to date. In documenting 2 patients who underwent bilateral mastectomy for clinical gynecomastia of unknown cause, we emphasize the need for a greater degree of clinicopathological awareness of highly active antiretroviral therapy-associated lipomastia and the role of the histopathologist in the informed management of patients afflicted with human immunodeficiency virus infection on highly active antiretroviral therapy.