Endocrine Abstracts

Introduction: Galactocele is a rare form of cystic, benign lesion of the breast, occurring when a mammary duct becomes obstructed and over filled with milk. It usually appears in postpartum women, either lactating or not, but it is extremely rarely seen in postmenopausal women or in men.

Subject: We present the case of a 37-year-old female patient, nullipara, diagnosed with a microprolactinoma 18 months ago, and treated with bromocriptine since then (7.5 mg daily). The ultrasound of the breast showed normal aspect. The patient stopped the treatment for 2 months and resumed it when prolactin levels rose again up to 100 ng/ml. On admission in our hospital, the physical examination revealed a large, painless left breast, with no localized masses at palpation. Ultrasound scan indicated a large cyst (>10 cm), with drop shadows inside. The mammography showed a large, homogenous cyst. Aspiration of the cyst revealed a milky fluid, rich in lipid droplets, and with no bacterial growth, confirming the diagnosis of galactocele. After the aspiration, the echographic image disappeared.

Particularities of the case:
1. The rarity of a galactocele in women not connected with pregnancy or lactation.
2. The possibility of hyperprolactinemia (even mild) due to the prolactinoma to induce the growth of the cyst.
3. The difficulty of etiological diagnosis based only on mammography and ultrasound.