A rare case of galactocele in a patient with macroprolactinoma. The hypothetical role of poor compliance with dopamine agonist therapy.

Galactocele is a rare clinical finding in males and is even more uncommon in the context of prolactin-secreting pituitary adenomas. Its occurrence raises important questions about the effects of hyperprolactinemia in men, especially when there is poor treatment adherence. We describe a 34-year-old man with type 2 diabetes who presented with erectile dysfunction, gynecomastia, and galactorrhea. Investigations confirmed hyperprolactinemia secondary to a pituitary macroadenoma. He was started on cabergoline, which improved his symptoms. However, after discontinuing therapy for several months, he developed a painful breast mass. Ultrasound and aspiration confirmed a galactocele-a finding rarely reported in adult males. The mass resolved after aspiration, and dopamine agonist therapy was resumed. This case highlights the importance of recognizing galactocele as a potential complication of untreated or poorly managed hyperprolactinemia in men. It underscores the need for sustained adherence to dopamine agonists and vigilance in evaluating male patients with gynecomastia and galactorrhea.