Persistent Hyperprolactinemia and Bilateral Galactocele in a Male Infant

Abstract

Galactocele is a benign breast lesion, usually occurring in nursing women. This lesion is a rare cause of breast enlargement in children. In this paper we describe the case of an infant with hyperprolactinemia (which persisted throughout 15 years of clinical observation) and bilateral galactocele. We speculate that a congenital midline defect in our patient might have impaired the normal dopaminergic inhibitory tone on pituitary lactotroph cells, thus leading to an increased prolactin secretion by the pituitary gland; this, in turn, might have favored the development of the galactocele.

Unilateral galactocele in a male infant

“…Simple excision through the intra-areolar incision was curative in all reported cases 2,4,[8][9][10][11] , as was in this patient. The needle aspiration of cyst fluid may eliminate the need for the surgery but there are only three such cases reported in the literature 4,5 .…”

“…However, one previously reported 28-month-old boy with unilateral galactocele had persistent hyperprolactinemia 8 and another 18-month-old infant with bilateral breast involvement had elevated insulin-like growth factor-1 because of growth hormone treatment of congenital hypopituitarism 9 . In only 3 reported cases, all with unilateral galactocele, isolated congenital malformation was described: renal dysplasia 1 , ventricular septal defect 10 , and cleft lip 11 .…”

A 6-month-old boy with bilateral breast enlargement

“…It has been proposed that it may be associated with stimulation by prolactin, ductal obstruction or the presence of secretory breast epithelium 3–5. It has been reported only in a single male infant with persistent hyperprolactinaemia and bilateral galactoceles 3. Dopamine receptor agonists (cabergoline or bromocriptine) may decrease serum prolactin levels, however hyperprolactinaemia was not present here.…”

An unusual case of bilateral galactocoele in a male infant

“…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.…”