Unilateral bloody nipple discharge in a two-month-old male

Praeter, Claudine De; Coen, Kris De; Vanneste, Katrien; Vanhaesebrouck, Piet

doi:10.1007/s00431-007-0482-3

Cited by 20 publications

(19 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…BND in childhood has been associated with benign and self‐limited processes. According to many authors, the most common underlying cause of BND is mammary duct ectasia 3–5 …”

Section: Case Reports Of Bloody Nipple Discharge In Pre‐pubertal Agementioning

confidence: 99%

Letter to the Editor

Sousa

Costa²,

Carvalho³

et al. 2010

J Paediatrics Child Health

View full text Add to dashboard Cite

At 6 months of age, the right temporal muscle was swollen. Serum CK level was elevated (CK 735 IU/mL). MRI depicted an increased intensity in the right temporal muscle. The swelling mass gradually resolved after 1 month. At 8 months of age, swelling of the right forearm was observed. The swelling was found to be a firm mass measuring 2 cm in diameter, which disappeared spontaneously after 1 week without specific treatment. Shortly after the disappearance of the right forearm mass, a few swollen masses appeared on the bilateral soles. No biopsies of the affected muscles were performed because of the absence of consent from the parents. No signs of polymyositis and dermatomyositis (e.g. fever, skin rashes and muscle weakness) had developed throughout the patient's clinical course.FM localised frequently in the lower limb (thigh and lower leg), and in temporal muscles in a few cases. 6 The clinical course, the result of laboratory tests and the MRI findings of our patient were consistent with the diagnosis of recurrent FM.Treatment for recurrent FM has not been established. Several treatment options have been attempted, including non-steroidal anti-inflammatory drugs, methotrexate and methylprednisolone; however, no consistent results have been obtained thus far. 2,4The aetiology of recurrent FM remains unknown. Manganelli et al.2 reported a case of a 22-year-old man who developed bilateral recurrent FM of the gastrocnemius muscles 3 weeks after receiving BCG vaccination. Our patient was administered BCG vaccination 2 months prior to the swelling of the left temporal muscle. In Japan, BCG vaccination is given to more than 1 million infants annually. However, recurrent FM has not been reported in Japanese children thus far. Therefore, if BCG vaccination is a possible trigger for recurrent FM, then host defence mechanisms might be associated with the development of the disorder. Interestingly, FM was reported to have developed in monozygotic twins. Recurrent FM occurred in one of the identical twins, while the other twin developed nonrecurrent FM.3 Further studies are necessary to identify genetic and environmental factors associated with recurrent FM.

show abstract

“…BND in childhood has been associated with benign and self‐limited processes. According to many authors, the most common underlying cause of BND is mammary duct ectasia 3–5 …”

Section: Case Reports Of Bloody Nipple Discharge In Pre‐pubertal Agementioning

confidence: 99%

Letter to the Editor

Sousa

Costa²,

Carvalho³

et al. 2010

J Paediatrics Child Health

View full text Add to dashboard Cite

show abstract

“…Bloody nipple discharge in infants, first described by Berkowitz and Inkelis, 1 occurs unilaterally or bilaterally in both sexes. 3,4 Underlying breast carcinoma should definitely be ruled out when we see patients with BND, but to our knowledge, it has never been reported in infants. 2 In laboratory examinations, coagulation test results and serum hormone levels are usually found to be normal, and culture of the discharge is usually negative.…”

mentioning

confidence: 94%

“…Most patients older than 1 year show a palpable mass or breast enlargement, whereas infantile patients sometimes present with a normal appearance. 4,5 From these data, mammary duct ectasia is the most likely cause of BND in infants and children, although the specific cause of duct ectasia remains unclear. Histopathologically, mammary duct ectasia, a benign lesion characterized by dilated ducts surrounded by fibrosis and inflammation, has been proven in more than half of childhood BND cases with palpable masses treated surgically.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Bloody Nipple Discharge in an Infant

Ujiie¹,

Akiyama²,

Osawa³

et al. 2009

Arch Dermatol

View full text Add to dashboard Cite

“…Bloody nipple discharge (BND) is a rare finding in neonates and infants. In contrast to BND in adults, BND in infants has been reported as a benign disorder 1–9 . Breast carcinoma under the age of three years has not been reported 3 …”

mentioning

confidence: 99%

Does bloody nipple discharge occur during normal breast development in infancy?

Tan

Bosstraeten

Casteels

2010

Pediatrics International

View full text Add to dashboard Cite

Bloody nipple discharge (BND) is a rare finding in neonates and infants. In contrast to BND in adults, BND in infants has been reported as a benign disorder. [1][2][3][4][5][6][7][8][9] Breast carcinoma under the age of three years has not been reported. 3 We report a case of unilateral BND in a 6-month-old boy and describe the cytological findings. An overview of the existing literature on normal breast development and BND and a hypothesis on the pathogenesis of BND is put forward. Case ReportA 6-month-old boy presented with painless unilateral BND (dark brown/red color) for one week. There was no breast hypertrophy. The boy was in good health and had no other complaints. There was no history of local trauma. He was exclusively breast-fed until the age of 4 months. Familial history was negative for bleeding diathesis, breast carcinoma or endocrine disorders. Mild pressure on the areola revealed a few drops of bloody discharge. Cytology of the nipple discharge was performed and showed fat cells, erythrocytes, eosinophils, neutrophils, and macrophages ( Fig. 1). There were no malignant cells. Culture of the fluid was sterile. Ultrasound of the breast revealed dilatation of the glandular ductile system. Mammary duct ectasia was diagnosed. The nipple discharge diminished gradually and resolved spontaneously within two months. Follow up until the age of 12 months was uneventful. Discussion Normal infant breast developmentFew data exist on the development and the growth of the human breast during the first months of life. 10-12 Breast hypertrophy in newborns with or without milky discharge is often seen. This phenomenon is sex independent. It is hypothesized that breast hypertrophy is caused by hormone excess either from maternal origin or from the gonads of the newborn itself. 4,10 McKiernan et al. studied the histology of breast development in infants who died between the age of 3 weeks and 2 years and found well-formed lobules, which contained dilated ducts filled with secretions. Foci of hematopoiesis were present. 10 Two other studies reported that development of the mammary ducts seemed to follow a certain chronology: cystic dilatation followed by regression with accumulation of eosinophilic and inflammatory cells around the basement membrane.

show abstract

Unilateral bloody nipple discharge in a two-month-old male

Cited by 20 publications

References 12 publications

Letter to the Editor

Letter to the Editor

Bloody Nipple Discharge in an Infant

Does bloody nipple discharge occur during normal breast development in infancy?

Contact Info

Product

Resources

About