“There’s something down there…”

Discussion: Breast tissue develops from “milk lines” of the ectoderm that extend along the anterior abdominal wall from the axilla to the labia majora. While normal breast development occurs on the upper chest, breast tissue can develop anywhere along these lines. [Fallat, Greydanus] Polythelia is the presence of an accessory nipple, and is found in 1-2% of the population, and is slightly more common in males. [Greydanus] Removal can be done for cosmetic reasons should the patient desire. Polymastia or accessory breast tissue may be found as well, but is less common than polythelia alone. Like normal breast tissue, ectopic breast tissue is also sensitive to hormonal influences and can hypertrophy as a result of puberty, pregnancy, or even lactation. (Greydanus) This accessory tissue is usually removed for both cosmetic and diagnostic purposes. Like normal breast tissue, accessory breast tissue can undergo malignant transformation giving more cause for removal.  [Peil, McMaster] There are other diagnoses that should be considered in the case of a groin mass in a child. A direct inguinal hernia can present as a unilateral mass in the labia. Although rare, a mass may be a gonad and be an indication of a sex difference. [Nussbaum] STIs are common and in particular, HPV can cause genital warts, which can be extensive in some patients. Although some strains are now preventable with vaccinations, most sexually active people will have detectable HPV at least once during their li...
Source: EPMonthly.com - Category: Emergency Medicine Authors: Source Type: news