2022, Number 05
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Ginecol Obstet Mex 2022; 90 (05)
Granulomatous mastitis: a cancer simulator, a great diagnostic and therapeutic challenge
Santiago-Sanabria L, Garza-Arrieta J, Tesone-Lasman JE, Benardete-Harari DN, Cortés-Rubio JL
Language: Spanish
References: 17
Page: 448-455
PDF size: 341.85 Kb.
ABSTRACT
Background: Idiopathic granulomatous mastitis is an extremely rare benign entity
of the mammary gland, simulating breast cancer. The most significant clinical manifestations
are: palpable nodule, skin discoloration changes and mastalgia. The diagnosis
requires the support of auxiliary imaging studies, although a biopsy is essential to establish
the definitive diagnosis. There are no well-established treatment guidelines, but
there are guidelines for pharmacological and surgical treatment, the latter is reserved
for cases of recurrence, which are frequent.
Clinical case: A 35-year-old nulligesta patient came for consultation due to the appearance
of a palpable tumor in the right mammary gland, of 7 months of evolution,
with changes in color and nipple retraction. The mastography and ultrasound catalogued
the tumor in BI-RADS 5. The biopsy with cutting needle and cytology integrated the
diagnosis of idiopathic granulomatous mastitis. Pharmacological treatment was indicated,
and the tumor disappeared spontaneously.
Conclusions: Granulomatous mastitis is a rare disease with a complex diagnosis.
For each patient there will be a different protocol to avoid overtreatment. Its prognosis
is good, despite being a breast cancer simulator. Treatment is still ambiguous but, in the
first instance, corticosteroids or immunosuppressants are recommended and surgical
treatment is reserved for cases of recurrence.
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