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Miscellanea
Images in paediatrics
An unusual case of bilateral galactocoele in a male infant
  1. Shiv Kumar Rajdev1,
  2. Niten Makwana2,
  3. Ruth Lester3,
  4. Juliana Chizo Agwu2
  1. 1Department of Paediatrics, Birmingham Children's Hospital, Birmingham, UK
  2. 2Department of Paediatrics, Sandwell and West Birmingham Hospital NHS Trust, West Bromwich, UK
  3. 3Department of Plastic Surgery, Birmingham Children's Hospital, Birmingham, UK
  1. Correspondence to Dr Juliana Chizo Agwu, Department of Paediatrics, Sandwell and West Birmingham hospital NHS Trust, West Bromwich, West Midlands B71 4HJ, UK; chizo.agwu{at}nhs.net

https://doi.org/10.1136/archdischild-2011-300431

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    A galactocoele is a very rare cause of breast enlargement in male infants.1 2 We present a case initially thought to be due to a prolactinoma.

    Case report

    An 11-month-old boy presented to our department with an 8-month history of progressive bilateral gynaecomastia and no other relevant history. The child was otherwise well and thriving. On examination, he had bilateral breasts Tanner stage 3, right>left. Both breasts felt cystic, with a pea-sized nodule palpable on the left (figure 1). A white fluid was expressed from the nipples. The rest of the examination was normal. Serum prolactin was initially raised (1151 mU/l) raising the suspicion of a prolactinoma; however, the MRI brain scan was normal and subsequent repeat prolactin was normal. Other investigations of the hypothalamic/pituitary/gonadal axis were normal. An ultrasound scan showed fluid filled cystic collections within both breasts. The diagnosis of bilateral galactocoele was made and confirmed following surgical excision (figure 2).

    Figure 1
    Figure 1

    Bilateral breast enlargement

    Figure 2
    Figure 2

    Surgical excision of galactocoele

    Conclusion

    A galactocoele is a rare, benign, milk-filled cystic lesion. It is usually unilateral although bilateral cases have been reported. The aetiology is unknown but it has been suggested that it may be associated with previous or present stimulation by prolactin, some form of ductal obstruction or the presence of secretary breast epithelium.3 4 Previous case reports have included a male infant with persistent hyperprolactinaemia and another with panhypopituitarism.3 5 In our case, the hyperprolactinanemia was transient. Surgical excision is curative.4 Paediatricians need to be aware of galactocoele as a differential diagnosis of breast enlargement in infants.

    References

    1. ↵
      1. Visvanathan R
      . Galactocoele of childhood—a case report. Singapore Med J 1990;31:500–1.
      OpenUrlPubMed
    2. ↵
      1. Boyle M,
      2. Lakhoo K,
      3. Ramani P
      . Galactocele in a male infant: case report and review of literature. Pediatr Pathol 1993;13:305–8.
      OpenUrlCrossRefPubMed
    3. ↵
      1. Tomasi PA,
      2. Fanciulli G,
      3. Casti T,
      4. et al
      . Persistent hyperprolactinemia and bilateral galactocele in a male infant. Int J Pediatr Endocrinol 2009;2009:578610.
      OpenUrl
    4. ↵
      1. Doneray H,
      2. Ozkan B,
      3. Erdogan F,
      4. et al
      . Bilateral galactocoele in a male infant. Turk J Med Sci 2008;38:481–3.
      OpenUrl
    5. ↵
      1. Rahman N,
      2. Davenport M,
      3. Buchanan C
      . Galactocele in a male infant with congenital hypopituitarism. J Pediatr Endocrinol Metab 2004;17:1451–3.
      OpenUrlCrossRefPubMed

    Footnotes

    • Competing interests None.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.