title: Bilateral mammary duct ectasia induced by sulpiride-associated hyperprolactinemia: A case report.
abstract: A 32 year old female diagnosed with schizophrenia was treated with sulpiride, trihexyphenidyl and alprazolam for 6 years. A physical examination revealed bilateral nipple retraction and a non-tender mass in the left breast, with little nipple discharge. Tests revealed high levels of carbohydrate antigen 125, serum prolactin and testosterone levels, and ultrasound revealed a number of masses in the bilateral breasts; the largest mass (2.2×1.3 cm) was located in the left breast. A rich blood flow signal was identified around the nodule. The ducts in the bilateral breasts exhibited cystic ectasia. Multiple enlarged lymph nodes were found in the bilateral axillae. Mammography revealed thickened breast tissue without an evident mass, and calcification. A segmental mastectomy was performed and subsequent histological examination revealed multiple dilated ducts, the largest of which contained eosinophilic material. The pathological diagnosis was of breast duct dilatation. Bacterial culture and drug sensitivity analysis of the secretions from the cystic cavity revealed no bacterial growth, and an acid fast bacillus stain was negative. Extravasation of the surgical wound occurred 1 month later, andStaphylococcus epidermidiswas observed using a bacterial culture. This was treated with moxifloxacin for 1 week. It was suggested that the patient should switch to a prolactin sparing antipsychotic in view of the hyperprolactinemia, however, the patient refused. After a clinical follow-up of 16 months, the wound had healed well and no palpable mass was found in the breast.
authors.affiliation: Department of Breast Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong 264400, P.R. China.
authors.forename: Yizi
authors.initials: Y
authors.lastname: Cong
authors.affiliation: Department of Breast Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong 264400, P.R. China.
authors.forename: Haidong
authors.initials: H
authors.lastname: Zou
authors.affiliation: Department of Breast Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong 264400, P.R. China.
authors.forename: Guangdong
authors.initials: G
authors.lastname: Qiao
authors.affiliation: Department of Breast Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong 264400, P.R. China.
authors.forename: Jun
authors.initials: J
authors.lastname: Lin
authors.affiliation: Department of Breast Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong 264400, P.R. China.
authors.forename: Xingmiao
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department of Breast Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong 264400, P.R. China.
authors.forename: Xiaohui
authors.initials: X
authors.lastname: Li
authors.affiliation: Department of Breast Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong 264400, P.R. China.
authors.forename: Yalun
authors.initials: Y
authors.lastname: Li
authors.affiliation: Department of Breast Surgery, Yantai Yuhuangding Hospital Affiliated to Medical College of Qingdao University, Yantai, Shandong 264400, P.R. China.
authors.forename: Shiguang
authors.initials: S
authors.lastname: Zhu
keywords: hyperprolactinemia; mammary duct ectasia; schizophrenia; sulpiride