ULCERATED GIANT GALACTOCELE IN A 30-YEAR-OLD WOMAN: A CASE REPORT FROM THE TAMALE TEACHING HOSPITAL IN THE NORTH REGIONAL CAPITAL - GHANA

Galactocele is a non-neoplastic cystic breast lesion found commonly in postpartum or lactating women.It may mimic neoplastic lesion because of the timing of its occurrence and or the clinicopathological changes in the affected breast tissue. It may thus pose a diagnostic challenge to clinicians in the absence of advanced imaging technology and histopathological examination. We present a 30-year-old woman para 7(5 alive, 2 dead) from the northern region of Ghana with an ulcerated giant galactocele of 4 years duration. The lesion started after the fourth child (aged 4 years) and progressively increased over the years to the current size at presentation. A diagnosis of galactocele was made by the surgeon based on the physical examination findings, supported by breast ultrasonography. CT scan of the head did not find any brain lesion. Similarly, a serum prolactin level was moderately elevated. She had simple mastectomy and histopathological examination of the breast specimen reported the lesion as an ulcerated giant galactocele. Conclusion: In the absence of any detectable pituitary adenoma and markedly elevated serum prolactin level, we rely on the short pregnancy intervals, duct obstruction and the long-standing chronic inflammation reaction with the associated fibrosis as the aetiological factors responsible for the pathology seen in this current case report.