Male Breast Lump: Case Report of Epidermal Cyst of the Breast

Abstract

INTRODUCTION: The intramammary epidermal cyst is rare. Its localization more common is back, neck and scalp. Mammograms and ultrasound can be variable, mimicking benign and malign diseases. This diagnosis rarely is suspected. The etiology is diverse: congenital, trauma (including breast surgery), occluded hair follicles, otherwise associated to fibroadenoma or fibrocystic disease when ductal ectasia is present. It can evolve and increases until rupture with pain, inflammatory process or abscess. These complications can be seen after breast surgical procedures for aesthetical, diagnostic or therapeutic reasons. The resection of epidermal cyst is diagnostic and therapeutic. CASE REPORT: A 45 years-old man has presented right breast painful lump since November 2010 associated to growing, purulent nipple discharge and flogistic symptoms which regressed spontaneously. He has never taken any drug. Physical examination has showed retroareolar lump in right breast measuring 2 cm, nipple discharge and without axillary lymphadenopathy. In December 2010, ultrasound revealed right retroareolar, irregular, hipoecogenic nodule measuring 2. 7 cm. In February 2011, the needle aspiration sample was suggestive of mammary cyst. In March 2012, mammogram showed right retroareolar, regular nodule measuring 5 cm and BI-RADS 0. He had normal exams: renal and hepatic biochemical exam; thyroidal and sexual hormones; and tumoral markers to testicular neoplasia. In Juny 2012, the resection was carried out and histopathological study was epidermal cyst and organizing abscess. DISCUSSION: We describe a rare case of epidermal cyst in man. This disease can appear in any age and your frequency is unknown. Most similar cases in literature were female. In this report, gynecomastia was excluded and clinical and radiological findings have suggested fibroadenoma. The differential diagnosis with epidermal cyst is difficult and uncommon for the reason that it can imitate benign and malign lesions. The histopathological study is the best to define it. The epidermal cyst can degenerate in squamous carcinoma: 0.5 to 19%. When treated, the epidermal cyst has an excellent prognosis.