Pant Ved Prakash, Mishra Deepak
B.P. Koirala Institute of Health Sciences.
Department of Pediatrics, Neonatal Division, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.
Ann Med Surg (Lond). 2023 Jul 19;85(8):4134-4136. doi: 10.1097/MS9.0000000000001036. eCollection 2023 Aug.
Giant mastauxe is an uncomplicated physiological enlargement of the breasts in newborns, characterized by a breast bud diameter greater than 3 cm. While most newborns have some degree of breast enlargement, giant mastauxe is rare, which may be unnecessarily intervened upon.
A 13-day-term male neonate presented with bilateral breast enlargement and milky nipple discharge, which worsened upon breast massage. The mother had an uneventful pregnancy, and neither the mother nor the baby had a history of drug intake. The examination revealed soft, non-tender, non-erythematous bilateral breast swellings measuring 3.6×3.8 cm on the right side and 3.2×3.4 cm on the left side. Ultrasonography confirmed their hypoechoic nature with minimum vascularization. The white blood cell count, C-reactive protein levels, and culture of nipple discharge yielded normal results. The baby was discharged, and upon follow-up after 2 weeks, it was observed that breast swellings had spontaneously reduced in size.
Neonatal breast enlargement can occur as a result of either the transplacental transfer of maternal estrogens or declining levels of estrogens toward the end of pregnancy, leading to hyperprolactinemia. However, the exact reasons behind the occurrence of giant mastauxe in some newborns remain incompletely understood. It may be due to increased sensitivity of the breast tissue to estrogens.
Proper clinical examination, along with the use of ultrasonography and/or laboratory investigations if required, is essential to differentiate giant mastauxe from neonatal mastitis or breast abscess. Treatment primarily involves observation and providing reassurance to parents.
巨大乳腺肿大是新生儿乳房的一种单纯生理性增大,其特征为乳腺芽直径大于3厘米。虽然大多数新生儿都有一定程度的乳房增大,但巨大乳腺肿大很少见,可能会受到不必要的干预。
一名13日龄男婴出现双侧乳房肿大及乳头溢乳,乳房按摩后症状加重。母亲孕期顺利,母亲和婴儿均无用药史。检查发现双侧乳房柔软、无压痛、无红斑,右侧大小为3.6×3.8厘米,左侧为3.2×3.4厘米。超声检查证实其为低回声性质,血管化程度最低。白细胞计数、C反应蛋白水平及乳头溢液培养结果均正常。婴儿出院,2周后随访观察到乳房肿大已自行缩小。
新生儿乳房肿大可能是由于母体雌激素经胎盘转运,或妊娠末期雌激素水平下降导致高催乳素血症所致。然而,一些新生儿发生巨大乳腺肿大的确切原因仍不完全清楚。可能是由于乳腺组织对雌激素的敏感性增加。
进行适当的临床检查,并在必要时使用超声检查和/或实验室检查,对于区分巨大乳腺肿大与新生儿乳腺炎或乳腺脓肿至关重要。治疗主要包括观察并向家长提供安慰。