Breast feeding can be difficult for many new moms, but it can be argued that a 29-year-old in Austria had much worse.
It was not just her breast that swollen, hurt and produced milk – it was also her vulva.
The doctors at Obstetrics and Gynecologic Endocrinology of Kepler University Hospital in Austria saw the woman only five days after her second baby was born.
She had been transferred to care because of complaints about swelling and pain in her vulva. There were some tears during the last birth, and she had received two sets of stitches in two different parts of the sensitive area.
"Upon handover, it reported to the patient that, on postpartum day four, she developed a milky white liquid bilateral discharge on the volcano," the team explains.
"She noticed a rising swelling on both sides, right and left and stretched from the labia majora to the labia minora and extended as far as the perineal area near the anus within 4 days of delivery."
The first thought was that something was crazy with the stitches; But the woman noted doctors that she had had similar symptoms after her first pregnancy.
In view of all this, the medical team realized that their patient had what is called ectopic (not in the usual place) breast tissue, right there in her outer genitals. An ultrasound confirmed the diagnosis.
Although there was no nipple, it was a channel ̵
This sounds like a completely bizarre situation, but it can be explained quite easily when we take a detailed look at the development of human breasts; They can be much more complicated than we think.
People – like any other mammal – have something called an embryonic milk line or chest. When we are still small embryos, this is the area in which our bodies will form nipples; In some of us it is along this line that we will also form mammary glands and breast tissue during puberty.
But here's the thing: Nipples and breast tissue can actually form anywhere along these milk lines. this is what causes things like third (or more) nipples along the milk line, or in this case breast tissue on the vulva.
Such a phenomenon is rare, but it is not unusual; a quick glance will reveal several other cases in the literature.
However, most of the time this ectopic breast tissue is not detected until it begins to show problems, such as pregnancy swelling or the development of a cancerous tumor. To treat such cancer cases, the tumor and breast tissue are removed, usually solving the problem.
In the case of the Austrian mother, it turned out that some of the stitches on one side had caused galactostasis, where the milk is backed up in a painful degree. To treat this, the doctor removed the stitches from the ectopic breast tissue and gave the patient antibiotics to treat inflammation.
Fortunately, the pain, swelling and milk of the volcano decreased in the next two weeks and the woman was able to continue breastfeeding without any other problems.
The researchers explain that she has not removed the breast tissue, even though they have discussed potential problems with tumors in the future.
"Because of the potential for developing malignancy in ectopic breast tissue, it seems wise to recommend excision of this tissue, although there are no guidelines for the management of extramammary breast tissue" explains the team
"Diagnosis is important to distinguish from other vulvar masses, such as vulvar carcinoma, and to control proper management. "The research has been published in Obstetrics & Gynecology .