Naseer, Faisal

Abstract Disclosure: A. Riaz: None. R. Haider: None. F. Naseer: None. S. Fatima: None. A. Khan: None. M. Mal: None. A. Qadeer: None. INTRODUCTION: Giant mastauxe is a rare neonatal condition characterized by excessive breast enlargement, with a breast bud diameter exceeding 3 cm. It is an exaggerated form of common neonatal breast enlargement (1 to 2 cm) that typically resolves within six months. This condition results from maternal estrogen withdrawal, which triggers prolactin release and breast tissue proliferation. Its pronounced presentation raises parental concern and requires clinical evaluation to exclude pathological causes. Very few reports exist in literature on it. Here we report a rare case of giant mastauxe, highlighting its presentation and management. CASE PRESENTATION: A 1-month-20-day-old male infant came with bilateral breast enlargement and milky discharge since birth. There was no history of trauma or redness. He was born at 39 weeks via vaginal delivery, weighing 3100g, with APGAR scores of 8 and 9 at 1 and 5 minutes, respectively. Mother had no history of antenatal infections or drug intake, except for iron, calcium, and folic acid supplements during antenatal visits.On examination, the respiratory rate was 54 breaths/min, heart rate 140 beats/min, temperature 98.5°F, and oxygen saturation 99%. Bilateral, non-tender, non-erythematous breast swelling with soft consistency and milky discharge was noted (right: 5.1×3.2 cm; left: 3.8×3.0 cm), with retracted nipples and no skin changes.Laboratory tests showed normal leukocytes and CRP. Ultrasonography revealed enlarged breasts with dilated ducts/cysts. Diagnosed as Giant mastauxe, malignancy and inflammation were ruled out. Treatment included Miconazole gel, Miconazole nitrate, Hydrocortisone cream, Iron polymaltose complex, Vitamin B complex, Vitamin C, and Lysine.After 3 weeks, follow-up showed reduced breast size with retracted nipples and no infection. DISCUSSION: Giant Mastauxe is breast bud enlargement more than 3 cm. Postnatally, falling maternal estrogen triggers prolactin secretion in the newborn’s pituitary, leading to breast stimulation and milk secretion in 5-20% of infants. The breast's engorgement correlates with plasma prolactin, implying the infant’s prolactin drives the response. The cause of exaggerated hormonal response in neonatal mastauxe is unclear but may involve heightened sensitivity to estrogen or prolactin. increasing the risk of malignancy later. Ultrasound typically shows hypoechoic tissue for diagnosis. The condition resolves on its own, and requires simple follow-up every two months. Presentation: Saturday, July 12, 2025

e16237 Background: Alcohol use (AU) and Liver cell carcinoma (LCC) are significant contributors to adult mortality worldwide. Examining trends and disparities in AU and LCC-related deaths is essential for understanding public health challenges and formulating targeted interventions. This study investigates national mortality patterns related to AU and LCC in the United States from 1999 to 2023, emphasizing demographic, geographic, and temporal disparities. Methods: This descriptive analysis used the CDC WONDER database (1999–2023) to identify AU-related deaths (ICD-10 codes E24.4, F10, G32.2, G62.1, G72.1, I42.6, K70, K85.2, K86.0, R78.0, T51, X65, Y15) and LCC (ICD-10 code C22.0) in adults aged 25 and older. Age-adjusted mortality rates (AAMRs) per 1,000,000 individuals were calculated, stratified by gender, race/ethnicity, census region, urban-rural classification, and state. Trends were analyzed using Joinpoint regression to compute annual percent changes (APCs) and 95% confidence intervals (CIs). Statistical significance was set at p < 0.05, and analyses adhered to STROBE guidelines. Results: From 1999 to 2023, a total of 21,007 deaths were attributed to LCC and AU (Men: 18,836 Women: 2,171). AAMRs showed a stable trend from 1999 to 2003 (APC: 0.0; 95% CI: -8.7 to 4.9) but increased significantly from 2003 to 2019 (APC: 6.1; 95% CI: 5.7 to 7.4), stabilizing from 2019 to 2023 (APC: -0.6; 95% CI: -3.2 to 1.3). Men's AAMRs decreased from 1999 to 2003 (APC: -1.1; 95% CI: -10.4 to 3.4), then rose sharply from 2003 to 2019 (APC: 6.1; 95% CI: 5.6 to 7.1). For women, AAMRs increased significantly, particularly between 2013 and 2017 (APC: 12.4; 95% CI: -9.5 to 25.1). Non-Hispanic Black and White populations experienced notable increases in AAMRs, while Hispanic people showed an initial decline followed by an increase post-2004 (APC: 4.7; 95% CI: 3.7 to 7.9). The West had the highest regional AAMR (5.3; 95% CI: 5.2 to 5.5), while the Northeast recorded the lowest (2.1; 95% CI: 2.0 to 2.2). New Mexico had the highest state AAMR (8.4; 95% CI: 7.4 to 9.4), and Mississippi the lowest (1.2; 95% CI: 0.9 to 1.5). AAMRs rose more sharply in non-metropolitan areas from 1999-2020 (APC: 6.6; 95% CI: 5.9 to 7.8) compared to metropolitan regions from 2004 to 2020 (APC: 5.4; 95% CI: 4.9 to 6.5). Conclusions: AU and LCC-related mortality rates have increased significantly since 2003, with distinct gender, racial, and geographic disparities. Men and rural populations faced higher mortality increases, with notable variations across states and regions. These findings underscore the need for focused public health efforts to mitigate these disparities and address the growing burden of LCC and AU-related mortality.