Diagnostic approach and clinical management of bloody nipple discharge

Bloody nipple discharge is a rare finding in infants and is most often associated to mammary duct ectasia. It is a benign course phenomenon and a differential diagnosis with other processes of different evolution, including tumour pathology, has to be established. We report a 4-months-old boy with unilateral bloody nipple discharge, without mammary hypertrophy and negative culture. Ultrasounds showed bilateral ductal ectasia. The course was self-limited to 3 months, without discharge of the contralateral breast in spite of the ultrasonography findings. Literature was reviewed, an approach to evaluation and an update of the clinical management according to the possible implied aetiologies, were also made.