Galactorrhea in the adolescent

Superior vena cava syndrome and gynecomastia in antiquity: Paleodermatologic considerations on aging in the past

We explore the antiquity of two well-known conditions often associated with advancing age, namely superior vena cava syndrome and gynecomastia, through the veristic sculptural representation dating back to the classical age. The statue of the Old Fisherman from the "Paolo Orsi" Regional Archaeological Museum of Syracuse, Italy, thanks to the extremely accurate rendering of the appearance of the cutaneous tissues, makes it possible to open a window to the antiquity and morphologic presentation of pathologic phenomena that would be difficult to infer solely from the human skeleton remains. The analysis of this statue also offers an opportunity to highlight the capacity of Hellenistic art in portraying human misery and illness.

Burns, hypertrophic scar and galactorrhea

An 18-year old woman was admitted to Motahari Burn Center suffering from 30% burns. Treatment modalities were carried out for the patient and she was discharged after 20 days. Three to four months later she developed hypertrophic scar on her chest and upper limbs. At the same time she developed galactorrhea in both breasts and had a disturbed menstrual cycle four months post-burn. On investigation, we found hyperprolactinemia and no other reasons for the high level of prolactin were detected.

She received treatment for both the hypertrophic scar and the severe itching she was experiencing.

After seven months, her prolactin level had decreased but had not returned to the normal level. It seems that refractory hypertrophic scar is related to the high level of prolactin in burns patients.

Nonneoplastic enlargement of the pituitary gland in children

Primary neoplasms of the pituitary gland are uncommon in children. Physiological enlargement of the gland, however, is universal and can sometimes be confused with a tumor. Due to widespread availability of MR imaging, the number of children referred to pediatric neurosurgeons with an enlarged pituitary associated with nonspecific symptoms, most commonly headache, is increasing. In this review, the authors illustrate two common causes of pituitary enlargement in children, namely physiological hypertrophy of puberty, more commonly seen in females, and secondary hyperplasia caused by hypothyroidism. The importance of early and accurate diagnosis, without recourse to extensive endocrine investigations or inappropriate surgery, is underscored.

Breast disorders in children and adolescents

A review of pediatric breast disorders is provided, with particular attention given to the topics of fibroadenoma, cystosarcoma phylloides, breast infections, breast cancer, and benign breast disease. The pediatric clinician is strongly encouraged to include the breast system as part of a complete examination and educational process.