Case Of Idiopathic Granulomatous Mastitis Research Articles

A case of idiopathic granulomatous mastitis that canmimic a breast cancer

Introduction: Idiopathic granulomatous mastitis (IGM) is an uncommon and persistent inflammatory breast disease with no identified cause. It affects women of reproductive age who have previously breastfed. Diagnosis of IGM is difficult because clinical and radiological features might mimic breast cancer. We report an unusual case of IGM in a breastfeeding mother mimicking breast cancer. Observation: A 32-year-old female patient, with no particular pathological history, has been presenting for 3 months mass of the right breast with erythema. A few weeks later, she presented a suppuration and ulceration of the right breast. The breast examination revealed a painless and poorly marginated mass, mobile in relation to the muscle plane and adherent to the skin at the junction of the external quadrants measuring 40*40mm. Breast ultrasound showed a heterogeneous hypoechoic irregular mass in the outer quadrants with surrounding edema, and dilatation of the milk ducts, classified as BI-RADS 4. Histologically, there was an epithelioid and gigantocellular granulomatous reaction of the mammary parenchyma, with a polymorphic inflammatory infiltrating of lymphocytes, plasma cells, and neutrophils. The patient received corticosteroids, bromocriptine, amoxicillin and clavulanic acid associated with topical care of the lesion. The evolution was favorable with the regression of the mass after 18 months. Discussion: IGM is an uncommon and benign condition that is frequently misdiagnosed. It mostly occurs in young women during the genital period. IGM does not have any pathognomonic mammographic characteristics. Breast ultrasound can show a nodular hypoechoic image with irregular contours with a long axis parallel to the skin. IGM is characterized by lobulocentric non-caseating granulomas made up of epithelioid histiocytes mixed with Langhan's multinucleate giant cells on histological examination. The treatment of IGM is not well established. The management of the disease is based on its clinical form. IGM is a gradual and recurrent disease that has a major impact on the quality of life and requires close surveillance. Conclusion: IGM is an uncommon and persistent inflammatory disorder of the breast that can be difficult to diagnose. Breast cancer is the predominant differential diagnosis, with the possibility of an association. Increased awareness of this disorder will lead to more accurate and timely diagnosis and treatment.

Granulomatous mastitis, erythema nodosum, and polyarthritis: a case report

BackgroundGranulomatous mastitis is a rare inflammatory disease of the breast, typically seen in woman of child-bearing age. No definitive etiology has been described. In rare instances, this condition has been reported to be associated with extramammary manifestations such as erythema nodosum and arthritis. We describe this rare condition in an adolescent female.Case presentationA 16-year-old, Hispanic female presented with right-sided painful breast swelling, polyarthritis, and erythema nodosum on bilateral shins and lower thighs. Physical examination was negative for lymphadenopathy and pulmonary, gastrointestinal, and cardiovascular findings. Ophthalmologic examination for uveitis and serologic tests for autoimmune diseases were negative. Diagnosis of idiopathic granulomatous mastitis was made by exclusion of other etiologies and conditions. Confirmation was made by histopathologic examination demonstrating noncaseating granuloma within breast lobules with neutrophils and microabscess formation. After wide local excision and a short course of trimethoprim–sulfamethoxazole, our patient was placed on naproxen and prednisone, the latter being tapered off over 3 months, with steady and complete resolution of all symptoms.ConclusionThis is the first reported case of idiopathic granulomatous mastitis in a pediatric patient who also had extramammary manifestations, including erythema nodosum and polyarthritis. In this case-based review, we summarize the phenotype, risk factors, prognosis, and treatment options of this rare condition, chiefly to make the readers cognizant of such a diagnostic possibility in similar clinical presentation in the future.

Idiopathic granulomatous mastitis: diagnostic dilemma

We report a case of Idiopathic granulomatous mastitis in a 21 years old female who came to our hospital with complaints of painful lump in her left breast because the results of initial excision of fibroadenoma, when re-exploration was done to rule out any foreign body – excision biopsy was done. However, the final histopathological diagnosis was granulomatous mastitis with suture granuloma, no evidence of malignancy. A review of literature revealed that idiopathic granulomatous mastitis has a tendency to affect young women. Clinical diagnosis and imaging has often been difficult. Complete resection or corticosteroid therapy can be recommended as appropriate treatment. Since recurrence rate is as high as 50%, long term follow up is indicated in such patients.

Evaluation of clinical manifestation and risk factors of idiopathic granulomatous mastitis

BackgroundIdiopathic granulomatous mastitis is a rare inflammatory breast pathology that, due to its rarity, remain challengeable for diagnosis. The disease has been suggested to have multiple etiologies. In this study the clinical manifestations and risk factors of idiopathic granulomatous mastitis (IGM) were assessed. Methods and materialsIn this case-control study 30 cases with idiopathic granulomatous mastitis and 60 control subjects in clinical centers in (XXX) in 2020 were enrolled and clinical manifestations and risk factors were determined and compared across the groups. ResultsThe breast mass (40%), pain (23.3%), and discharge (36.7%) were significantly higher in idiopathic granulomatous mastitis versus control subjects (P = 0.001). Passive smoking was seen in 3 cases (10%) and none of the subjects in case and control groups, with significant difference (P = 0.035). Age, contraceptive use, tuberculosis, malignancy, family history, breastfeeding duration, child count, and gravid were significantly different between the groups (P > 0.05). ConclusionsOur study showed that breast mass, pain, and discharge are main clinical manifestations in idiopathic granulomatous mastitis cases and passive smoking is the main risk factor for this disease. The role of pregnancy, lactation, smoking and use of oral contraceptive in the etiology of the disease still remains unclear.

A Fascinating Experience with A Rare Case of Granulomatous Mastitis

We Report a case of Idiopathic granulomatous mastitis in a 30 year old pregnant woman who came to our hospital with complaints of painful lump in her right breast because the results of initial aspiration cytology was mammary abscess with focal mastitis, incision and drainage was performed when MRI breast showed intermediate concern for malignancy – Excision biopsy was done. However the final histopathological diagnosis was granulomatous mastitis with no evidence of malignancy. A review of literature revealed that idiopathic granulomatous mastitis has a tendency to affect young woman with a history of child birth on oral contraceptive usage. Clinical diagnosis and imaging has often been difficult. Complete resection or corticosteroid therapy can be recommended as appropriate treatment. Since recurrence rate is as high as 50%, long term follow up is indicated in such patients.

La mastite granulomateuse idiopathique: à propos de 4 cas et revue de littérature

La mastite granulomateuse idiopathique est une mastopathie bénigne inflammatoire rare. L´examen histologique d´une biopsie chirurgicale permet de confirmer le diagnostic et écarter ainsi une mastite carcinomateuse. Bien que d’étiologies indéterminées et survenue surtout chez la femme jeune, son caractère idiopathique est retenu après élimination des autres causes de la maladie granulomateuse. Le traitement médical repose sur l´antibiothérapie et les anti-inflammatoires. Il est chirurgical dans les formes compliquées. Nous rapportons quatre cas de mastite granulomateuse idiopathique colligés au sein du Service de Gynécologie et Obstétrique de l´Hôpital Universitaire MED VI d´Oujda, Maroc.

Mycophenolate mofetil as a successful therapy for idiopathic granulomatous mastitis

Idiopathic granulomatous mastitis (IGM) is a benign chronic inflammatory breast disease of unknown etiology. No consensus exists as to the best therapeutic approach, though treatment choices include antibiotics, drainage, surgical excision, steroids, methotrexate, and observation. Herein we report a case of idiopathic granulomatous mastitis that was refractory to methotrexate and intralesional and systemic steroids but responded well to mycophenolate mofetil 1500mg twice daily. To our knowledge, this is the first report of the effective use of mycophenolate mofetil in idiopathic granulomatous mastitis.

A case of idiopathic granulomatous mastitis associated with erythema nodosum, reactive cough and arthritis

A case of idiopathic granulomatous mastitis associated with erythema nodosum, reactive cough and arthritis

Cytological Features of Granulomatous Mastitis-A study of ten cases

Introduction: Granulomatous mastitis is a rare benign disease, the exact cause of which is still unknown. It usually presents as a mass which may simulate carcinoma. Many patients are put on long term antibiotics because of breast abscess suspicion, but are not cured. This disease usually affects women of child-bearing age with a history of oral contraceptive use. Most cases have been reported in third decade. In previous studies most of cases of idiopathic granulomatous mastitis were within six years of pregnancy. There are two types of granulomatous mastitis, specific and idiopathic. Aim: To study cytological features of granulomatous mastitis, the age group involved and how to differentiate it from malignancy to prevent unnecessary mastectomies. Method: FNAC was performed with 22G needle. Slides prepared were stained with leishman stain. Special stains like Zeihl Nelson stain and Periodic Acid Schiffs were done to rule out mycobacterium and fungal etiology. Result: Cytological features of noncaseating granuloma along with plenty of polymorphs in the background is suggestive of granulomatous mastitis. History of lactation and oral contraceptives along with special tests further aids in its diagnosis. Conclusion: In this study of ten cases we describe the importance of cytology in diagnosis of granulomatous mastitis which helps us to prevent unnecessary mastectomies. GM is essentially a diagnosis of exclusion that is by excluding other causes of chronic inflammation. Infective causes such as tuberculosis should always be ruled out before stating treatment with steroid. Keywords: Breast, Mastitis, Granuloma, Polymorphs

Granulomatous mastitis: A retrospective review of 49 patients

Amac: Idiopatik granulomatoz mastit, nadir gorulen, benign, kronik inflamatuar bir hastalik olup meme kanserini taklit eder. Bu calismada idiopatik mastitli 49 hastanin tedavisini ve klinigini sunmayi amacladik. Yontemler: Hastane otomasyon sisteminde 2007-2012 yillari arasinda histolojik olarak granulomatoz tanisi konulmus hastalar incelendi. Hastalara ait klinik bulgular, demografik veriler ve tedavi yontemleri kaydedildi. Bulgular: Ortalama yas 37.71±7.1 idi. Tedavi gruplar arasinda etiyolojik ve demografik acidan istatistiksel fark yoktu. Nuks oranlari grup 1, grup 2 ve grup 3’te sirasiyla %8,3, %14,8 %20 olup, gruplar arasinda istatistiksel anlamli farklilik yoktu. Sonuc: Steroid ve cerrahi tedavinin idiopatik granulomatoz mastitli hastalarda uygulanabilecegini, steroid tedavisinin ilk basamak tedavi olmasi gerektigi kanaatindeyiz. Bununla birlikte tedavi algoritmasi belirlenebilmesi icin prospektif, randomize klinik calismalara ihtiyac vardir

A rare case of idiopathic granulomatous mastitis associated with erythema nodosum

A rare case of idiopathic granulomatous mastitis associated with erythema nodosum

A rare case of idiopathic granulomatous mastitis associated with erythema nodosum

Idiopathic granulomatous mastitis (IGM) is a rare benign chronic inflammatory disease. Etiology is unknown, but an autoimmune mechanism is suspected. Erythema nodosum is rare extramammillary manifestation of IGM, and few cases have been reported in the literature. In this study, we presented 28-year-old female patient with IGM associated with erythema nodosum. IGM can be caused by autoimmune mechanism and treated with steroid or surgical treatment. J Clin Exp Invest 2015; 6 (1): 84-85 Key words: Idiopathic granulomatous mastitis, erythema nodosum, steroid, surgery

A case of recurrent idiopathic granulomatous mastitis

We report a case of 46-year-old female patient who presented with a breast lump and was diagnosed as a case of idiopathic granulomatous mastitis. Patient was put on steroid therapy and her lesion completely disappeared, both clinically and radiologically. When we stopped the steroid therapy, the mass again recurred and patient had to undergo lumpectomy with no recurrence in follow-up of 1 year.

Idiopathic granulomatous mastitis: A report of twenty cases

Idiopathic granulomatous mastitis is a benign lesion of the mammary gland characterised by the presence of non-infectious inflammatory breast lesions limited to the lobules. We report twenty cases of idiopathic granulomatous mastitis (IGM) with a discussion of epidemiology, clinical and diagnostic features, treatment and progress of this pathological entity. A retrospective study of twenty cases compiled from a ten-year period, from 952 pathological anatomy examinations carried out to investigate various breast pathologies. The patients had a mean age of 45.5 years. Clinical examinations revealed a tumefaction measuring between 2.5 and 18 cm in diameter. The mean size was 5.5 cm. Mammography showed nodular lesions and sonography demonstrated hypoechoic nodules. On histological examination there was a granulomatous inflammatory infiltrate of epithelioid and giant cells, without caseation necrosis, made up of lymphocytes, plasma cells and neutrophils. Microbiology investigations were negative. Lesion involvement was principally lobulocentric. Surgical excision of the lesions was combined with corticosteroid therapy in twelve cases, with non-steroidal anti-inflammatory drugs in another four and with antibiotic therapy in four cases. The patients made good progress in the short-term. IGM is a rare entity. It poses a problem of differential diagnosis because it clinically resembles other forms of mastitis. The diagnosis can be made with certainty on histological studies. The treatment is medical alongside surgical excision. The prognosis of this disease remains favourable.

Mastite granulomatosa idiopática: aspectos clínicos, radiológicos e ultra-sonográficos

O objetivo deste estudo é descrever as características clínicas, mamográficas e ultra-sonográficas de três casos de mastite granulomatosa idiopática. Esta afecção pode simular câncer de mama nos exames clínico e mamográfico, porém os achados ultra-sonográficos de múltiplas imagens tubulares hipoecóicas, contíguas e confluentes em mulheres jovens com história de lactação recente sugerem o diagnóstico de mastite granulomatosa idiopática.

Mastite granulomateuse idiopathique : à propos de huit cas avec revue de la littérature

Aim of the study. – The authors report eight cases of idiopathic granulomatous mastitis in which the epidemiological, clinical, diagnostic, therapeutic and prognostic features are discussed. Material and methods. – Retrospective study of eight cases registered among 2,000 breast anatomopathological study during 5-years period. Results. – The mead age was 44,3 years. Breast lump measuring 2,5 to 15 cm in size was noted at clinical examination. Mammography noted nodular opacities and ultrasonography showed hypoechoic nodules. Histological findings were consistent on granulomatous inflammation centred on mammary lobules. The inflammatory infiltrate was including leukocytes, lymphocytes, plasma cells as well as epithelioid and giant cells without caseous necrosis in the granuloma. Discussion and conclusion. – Idiopathic granulomatous mastitis is a rare entity. This entity can clinically mimic other breast mastitis disease. Diagnosis is assessed by histological analysis This disease can be treated with drugs and surgical excision of the lump. The prognostic of this chronic disease is favourable.

Idiopathic Granulomatous Mastitis: Case Report and Review of the Literature

We report a case of idiopathic granulomatous mastitis in a 35-year-old Japanese woman, who came to our hospital complaining of a tender mass in her right breast. Because the results of initial aspiration cytology were considered highly suspicious for carcinoma, modified radical mastectomy was performed. However, the final histological diagnosis was granulomatous lobular mastitis with no evidence of malignancy. Idiopathic granulomatous mastitis is a rare inflammatory breast disease of unknown etiology. Since the clinical manifestations are similar to those of mammary carcinoma, this condition has been misdiagnosed as carcinoma and treated as such. A review of the literature revealed that idiopathic granulomatous mastitis has tended to occur in young patients with a history of childbirth or oral contraceptive usage. Clinical or imaging diagnosis has often been difficult. Complete resection or corticosteroid therapy can be recommended as the optimal treatment. Since 38% of patients experience recurrence, long-term follow-up is indicated.