RESUMENLa descarga de sangre a través del pezón (telorragia) es un síntoma muy infrecuente en pediatría. Si bien genera gran preocupación y alarma por su equivocada asociación con el carcinoma de pacientes adultos, en los niños se asocia, en la mayoría de los casos, con una ectasia ductal benigna. Hasta el momento, sólo existen informes o series de casos y, aunque se proponen diferentes teorías, la causa no se conoce con exactitud. Se presentan dos casos con características clínicas y evolución muy similar, en los que el sangrado se resolvió en forma espontánea, uno en cuatro y el otro en seis semanas. Se realiza una revisión del tema y, dado que se trata de un proceso benigno y autolimitado, se sugiere, en ausencia de otros hallazgos en el examen físico, realizar estudios mínimamente invasivos, adoptar una conducta expectante y tranquilizar a la familia en la espera de una resolución espontánea. Palabras clave: telorragia, ectasia ductal, sangrado a través del pezón. SUMMARYBloody discharge from the nipple (thelorrhagia) is a rare symptom in childhood and is a cause of great concern due to the mistaken association with carcinoma in adults. However, in children thelorrhagia is due to benign mammary duct ectasia in the majority of cases. Up to date, only isolated case reports or case series have been published and, although different theories have been postulated, no definite etiology has been identified. We report two cases with similar clinical features and outcome, in whom bleeding resolved spontaneously 4 and 6 weeks after onset. We present a review of the literature. Based on the benign and self-limiting process and in the absence of other findings on physical examination, we suggest a watch-and-wait approach with minimally invasive studies and reassurance and support for the family as most cases resolve spontaneously.
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