Galactocele in a young male patient

Does Male Infantile Galactocele Always Necessitate Surgical Intervention?

Galactocele is cystic dilatation of the mammary gland, which contains milk. Galactocele is usually presented as a painless breast enlargement with a fluctuant, soft, mobile, and non-tender mass in the breast. It is a rare disorder in the male pediatric age group, with only 31 cases reported in the literature. In this article, we present another case of unilateral galactocele in a 14-month-old male infant. Ultrasound imaging confirmed a simple cystic hypoechoic mass in the right breast, and needle aspiration was performed before surgery as a diagnostic procedure (a 1-cc extract revealed a milky-colored fluid).

Bilateral galactocele in a male infant with Down syndrome and congenital hypothyroidism

Galactocele is an uncommon benign breast lesion. Its cause is unknown. Here, we report a male infant with Down syndrome and congenital hypothyroidism during the newborn period. At follow up, when he was 6 months old, bilateral mammillary swelling was detected and diagnosed as galactocele. Although thyroid hormone levels were normal, serum prolactin levels were elevated. Cyst aspiration was performed on the left side and 6 months after the aspiration of the cyst on the left side, both cysts had clinically and sonographically regressed. No recurrence was observed at the end of the 4th year.

Unilateral pseudogynecomastia: an occupational hazard in manual metal-pressing factories?

BACKGROUND

Five cases of unilateral occupation-related pseudogynecomastia are presented. All the patients in these cases worked in the same metal-pressing factory.

METHODS

One patient with grade 4 unilateral gynecomastia in the right breast presented to the authors' outpatient department asking persistently for surgery. He also reported that all his male colleagues working in the same business (a total of 5) had different degrees of unilateral gynecomastia. Their line of work involved holding a long round rod under the axilla and then pressing the distal end of it firmly against a spinning metal plate. The patient underwent a superior pedicle breast reduction, with 1,800 ml of tissue removed from his right breast. Unfortunately, the patient experienced partial nipple loss. However, he was satisfied with the final result, and good symmetry was achieved.

RESULTS

All five patients who worked in the same metal-pressing factory presented with unilateral gynecomastia and were examined in our department. Their average age was 51.4 years. All the patients had normal hormonal and biochemical status, and the results of screening for toxins and heavy metal exposure were negative. All the patients were heavy smokers. At examination, none of the patients had nipple discharge or retraction, skin changes, galactorrhea, or lymphadenopathy. Examination showed one patient with grade 4, three patients had grade 2, and one patient with grade 1 unilateral gynecomastia.

CONCLUSIONS

The authors believe that gynecomastia may be considered an occupational risk in analogous metal-pressing factories because all the workers in this factory presented with some degree of unilateral gynecomastia. However, they emphasize that this may simply be an observational phenomenon without a true cause and effect relationship.

The galactocele of male infants: an intriguing entity. Study and reflection about a case, with review of the literature

In this report, the authors investigate and discuss a galactocele that developed in the breast of a 5-month-old male. Based on the histological and immunohistochemical findings, they suggest that the rare and intriguing process that is exclusively observed in males in the absence of any detectable hormonal stimulation at time of investigation could represent a developmental anomaly possibly promoted by an obstructive phenomenon involving a defect of hollowing of some primary epidermal buds, the precursors of the mammary ducts.

A late complication of augmentation mammoplasty by polyacrylamide hydrogel injection: ultrasound and magnetic resonance imaging findings of huge galactocele formation in a puerperal woman with pathological correlation

Polyacrylamide hydrogel (PAAG) was widely used for injection augmentation mammoplasty in Eastern Europe and China although uncommon in the western countries. However, the safety of this procedure remained controversial. Herein, we report a 30-year-old woman with a history of augmentation mammoplasty by PAAG injection developed galactoceles during her pregnancy. Ultrasound and magnetic resonance imaging showed huge cystic lesions in bilateral breasts; as a result, the normal breast tissue was almost completely replaced. On the basis of the imaging findings, the patient underwent mastectomy as well as immediate breast reconstruction with satisfactory outcome. It is important to be familiar with the imaging findings of this rare yet severe complication after augmentation mammoplasty in order to make an accurate diagnosis and a proper management.

On the neglected entity of unilateral gynecomastia

Although there are many articles in the literature on the etiology, classification, and management of gynecomastia, the entity of unilateral gynecomastia has not received much attention. In this article, 15 consecutive males (seen over a 10-year period) with unilateral gynecomastia were retrospectively reviewed. The study showed the unique presentation in this group of patients. One third of the patients (n = 5) had "cancer phobia" and were worried either because of the presence of a mass (n = 2) or because of the unilaterality of their disease (n = 3). The study also showed the predominance of true (glandular) gynecomastia, and this has also been observed in other cases of unilateral involvement in the literature. All patients underwent preoperative mammography. Mammographic findings were consistent with gynecomastia in all patients, including the 2 patients with concurrent breast masses. All patients underwent subcutaneous mastectomy, and histologic examination confirmed the diagnosis. Finally, the literature on unilateral gynecomastia was reviewed.