Images in paediatrics

thriving. On examination, he had bilateral breasts Tanner stage 3, right>left. Both breasts felt cystic, with a pea-sized nodule palpable on the left (fi gure 1). A white fl uid was expressed from the nipples. The rest of the examination was normal. Serum prolactin was initially raised (1151 mU/l) raising the suspicion of a prolactinoma; however, the MRI brain scan was normal and subsequent repeat prolactin was normal. Other investiga-tions of the hypothalamic/pituitary/gonadal axis were normal. An ultrasound scan showed fl uid fi lled cystic collections within both breasts. The diagnosis of bilateral galactocoele was made and confi rmed following surgical excision (fi gure 2). CONCLUSION A galactocoele is a rare, benign, milk-fi lled cystic lesion. It is usually unilateral although bilateral cases have been reported. The aetiology is unknown but it has been suggested that it may be associated with previous or present stimulation by prolactin, some form of ductal obstruction or the presence of secretary breast epithelium.3 4 Previous case reports have included a male infant with persistent hyperprolactinaemia and another with panhypopituitarism.3 5 In our case, the hyperprolactinanemia was transient. Surgical excision is cura-tive.4 Paediatricians need to be aware of galactocoele as a dif-ferential diagnosis of breast enlargement in infants