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.

Galactocele in Male Infants: Report of Two Cases and Review of the Literature

“…22 The first case of a galactocele was reported back in 1880 10 and since then only another 23 cases have been published, usually as a single case reports, with only 2 articles describing 3 and 2 cases, respectively 13,20 (►Table 1). Galactoceles are frequently unilateral but in over 30% of cases (8/26) they occurred bilaterally 3,8,12,15,16,20,21 (►Table 1). The median age at onset was 7 months, and the median age at clinical presentation was 15 months (►Table 1).…”

“…20,23 Galactocele can occur in cases with persistent hyperprolactinemia. 21 Furthermore, elevated insulin-like growth factor-I resulting from growth hormone treatment of congenital hypopituitarism has been reported to contribute to the enlargement of galactocele. 19 No endocrine abnormalities were found in one of our patient whereas the other one had no further tests done as they were regarded as unnecessary.…”

“…Needle aspiration of the cyst is usually performed by surgeons during diagnostic or operative procedures. 4,21 Some authors considered the needle aspiration technique a very invasive diagnostic procedure. 2 It has been reported that the aspiration may eliminate the need for surgery but there are only three such cases in the literature.…”

“…Most authors agree that the treatment of galactocele is surgical and simple excision through the intra-areolar incision is curative in all patients. 2,3,5,7,8,14,15,[17][18][19]21 Some authors have suggested that with the time secretory activity of the cysts ceases with its eventual replacement by a small mass containing inspissating secretory material, 5,14 but even their patients had surgical treatment as they felt that a persistence of a breast lump into adult life would be a cause of concern.…”

Galactocele of adult male breast: A cytopathologist's perspective

“…Lau et al found scanty lymphocytes and absence of malignant cell in aspirated fluid from galactocele of 16‐month‐old boy . Tomasi et al described presence of very rare histiocytes and lymphocytes at the cytological analysis of the aspirated milky fluid from galactocele of 26‐month‐old boy . Histopathological examination of the resected specimens showed cysts containing milk like fluid, lined by cuboidal to columnar epithelium where some of the epithelial cells had clear intracytoplasmic secretory vacuoles …”