Family polythelia associated with dental anomalies: a case report / Politelia familiar asociada con anomalías dentarias: un caso clínico

Abstract Polythelia is defined as the presence of supernumerary nipples without the presence of additional mammary gland, within the milk line extending from the axilla to the pubic region. Though the presence of dental anomalies can create a simple esthetic problem with specific clinical considerations, the association with familial polythelia has rarely been reported. A report of association of dental anomalies and polythelia in an Argentine family is presented and the considerations about the dental practice suggesting a careful anamnesis and referral to a medical consultation with regard to possible pathologic conditions or potentially malignant transformation of accessory breasts are discussed.

Resumen La politelia ha sido definida como la presencia de pezones supernumerarios sin tejido accesorio glandular; generalmente, éstos siguen las líneas mamarias que discurren imaginariamente desde las axilas hasta la región inguinal. Si bien la presencia de anomalías dentarias puede originar un simple problema estético con específicas consideraciones clínicas, la asociación con politeliafamiliar ha sido escasamente informada. Se presenta un caso de politelia asociada con anomalías dentarias en una familia argentina, y se discuten sugerencias para una cuidadosa anamnesis odontológica y derivación a la consulta médica para prevenir eventuales condiciones patológicas o una potencial transformación maligna de los tejidos mamarios.

Two Cases of Supernumerary Nipple

PURPOSE: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. METHODS: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a 2.8 x 3.1 cm-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. RESULTS: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. CONCLUSION: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

Two Cases of Supernumerary Nipple

PURPOSE: Supernumerary nipple or polythelia is one of the developmental anomalies occurring at the embryonic stage and this anomaly usually arises from the milk line. While this atypical feature is determined during early developmental stage, it may not come out obviously or become troublesome until puberty or lactation. Moreover, sometimes it is confused with a pigmented nevus. METHODS: Case 1, a 18-year-old woman with intramammary supernumerary breast consisted of another nipple with middle sized areola on the right lower breast was admitted for a 2.8 x 3.1 cm-sized mass on the right breast which was starting appeared 1 year earlier. The preliminary cytological examination of the material obtained by needle aspiration biopsy from the mass was revealed by fibroadenoma with no malignant change. The patient had the surgical excision of the mass and accessory breast. Case 2, a 16 year-old woman admitted for intra-areolar polythelia of the left breast, even she doesn't have any family history of polythelia. Since she wanted surgical correction of her atypical nipple for aesthetic and psychological reasons, we reconstructed the areola using transposition flaps in an S-plasty design. RESULTS: Case 1, the excised supernumerary nipple showed following histological features. In the superficial layer, an acanthotic and hyperpigmented epithelium with elongated rete ridges was found. In the dermis, there were follicles with hairs surrounded by hypertrophic sebaceous glands. In the deepest portion, abundant secretory glomerules and excretory ducts of apocrine gland type were observed. Case 2, follow-up visits 3 months after the procedure showed a satisfactory result with good shape and projection of the nipple. CONCLUSION: We report two cases of aberrant mammary tissue who underwent surgical correction, including complete breast (with nipple, areola, and glandular tissue) and intra-areolar polythelia according to the Kajava's classification, and the results were satisfactory.

Male Polythelia

Supernumerary nipples or polythelia are developmental abnormalities located along the embryonic mammary lines. It occurs sporadically but familial aggregation was been reported. Polythelia has been reported in association with congenital malformations, in particular with renal anomalies. We report a case of polythelia.

Ocorrência de tetas supranumerárias em caprinos sem raça definida do Estado do Ceará, Brasil / Occurrence of supernumerary teats in no-described goats from Ceará State, Brazil

A caprinocultura nordestina é principalmente produtora de carne, mas a espécie caprina é por excelência produtora de leite. As características da glândula mamária não devem ser negligenciadas, fazendo-se seleção contra tetas defeituosas de matrizes e reprodutores. Foram amostrados 485 caprinos sem raça definida (SRD) em 21 rebanhos no Estado do Ceará, em 1991. Em cada uma das microrregiões homogêneas do Estado, foram amostrados na razão de 0,05 por cento dos caprinos existentes (IBGE, 1988), em um ou mais rebanhos. Dentro do rebanho, a escolha dos animais se deu ao acaso. Todos os machos amostrados eram inteiros. No conjunto do Estado, observou-se que 27 por cento dos animais (n=131) apresentavam tetas supranumerárias: acessórias (não fundidas) ou papilas mamárias duplas (fundidas). Nas diversas mesorregiões do Ceará, os percentuais de animais com defeitos desta natureza, foram de 26,8 por cento no Nordeste, 26,6 por cento no Centro-Leste e 31,6 por cento no Sul. Do total de animais defeituosos, 62,9 por cento apresentavam uma teta acessória de cada lado, 29,6 por cento uma teta acessória em apenas um dos lados, 4,5 por cento mais de uma teta acessória de um ou ambos os lados; 3,0 por cento apresentavam papila mamária dupla em um ou ambos os lados. Apresentaram algum dos defeitos mencionados 16,7 por cento dos machos adultos (n=24), 25,4 por cento dos machos de recria (n= 63), 33,3 por cento das fêmeas de recria (n=72) e 26,7 por cento das fêmeas adultas examinadas (n=326). O número de animais defeituosos não difere entre mesorregiões, entre sexos ou entre faixas etárias (p>0,05). Concluiu-se que é alto o percentual de animais defeituosos e que os criadores devem ser orientados quanto à importância e o modo de seleção de matrizes e reprodutores para estes parâmetros.