214 www.paediatricstoday.com 1 Clinical Hospital Split Department of Pediatrics Split, Croatia, 2 Private Clinical Practice for Breast Diseases, Split, Croatia Corresponding author: Ivana Unic Sabasov Clinical Hospital Split Department of Pediatrics Spinciceva 1 21000 Split Croatia iunic@kbsplit.hr Tel.: + 385 21 556 287 Fax.: + 385 21 556 590 Received: February 15, 2013 Accepted: June 10, 2013 Copyright © 2013 by University Clinical Center Tuzla. E-mail for permission to publish: paediatricstoday@ukctuzla.ba BLOODY NIPPLE DISCHARGE IN INFANCY Ivana UNIC SABASOV 1 , Veselin SKRABIĆ 1 , Vedrana BULJEVIĆ 2 Paediatrics Today 2013;9(2):214-216 DOI 10.5457/p2005-114.79 Objective – We present three infants with bloody nipple discharge (BND). Tis rare clinical entity is mostly related to benign condi- tions such as ductal ectasia and epithelial hyperplasia. However, BND may be the frst symptom of breast carcinoma and for this reason, it causes anxiety in parents. Case reports – Te infants were older than six-months with unilateral left-sided BND and had normal physical exams. Haematological and endocrinological test results were within normal limits in all but one infant, who had increased follicle stimu- lating hormone and prolactin. Ultrasonography of the breasts showed asymmetry in the quantity of mammary tissue and the discrete di- lated ducts. Cytologic examination of the BND did not reveal any infammatory signs or atypical cells. Te BND resolved spontaneously within six months without any specifc treatment. Conclusion – Our fndings confrm previously reported observations that BND in in- fants is associated with ductal ectasia and epithelial hyperplasia. Tis condition is benign and disappears spontaneously so no specifc man- agement intervention is needed. Key words: Bloody nipple discharge ■ Infant ■ Mammary duct ectasia ■ Hyperplasia ■ Management. Case report Introduction Infantile bloody nipple discharge (BND) is a rare clinical entity mostly related to benign conditions such as ductal ectasia and epithe- lial hyperplasia (1-3). Parents may be anxious if they believe BND to be the frst symptom of breast carcinoma. We report three cases of unilateral infantile BND associated with both ductal ectasia and epithelial hyperplasia, including management recommendations. Case reports Te frst case was an 11-month-old male in- fant. Te second case was a nine-month-old female infant. Both infants presented with a unilateral bloody discharge from the left nip- ple that appeared 20 and 45 days before the frst examination, respectively. Te third case was a six-month-old male infant with bloody discharge from the left nipple which appeared a few days before the frst examination. Te deliveries were uneventful, the infants were breastfed and their mothers were not taking any medication. At the time of presentation, all breasts were normal in colour and without palpable masses. On light pressure, a bloody discharge appeared from only the left nipple in all infants. Hematological and endocri- nological test results were within normal limits. In only the third infant, the follicle