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Ruptured epidermal inclusion cysts in the subareolar area: sonographic findings in two cases.

Whang IY, Lee J, Kim JS, Kim KT, Shin OR - Korean J Radiol (2007 Jul-Aug)

Bottom Line: Epidermal inclusion cyst of the breast is an uncommon benign lesion and it is usually located in the skin layer.We report here on two cases of ruptured epidermal inclusion cysts in the subareolar area, which is a very unusual location for these cysts and these lesions can be mistaken for breast malignancies.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Uijongbu St. Mary's Hospital, Catholic University College of Medicine, Kyunggido 480-717, Korea. tiger@catholic.ac.kr

ABSTRACT
Epidermal inclusion cyst of the breast is an uncommon benign lesion and it is usually located in the skin layer. We report here on two cases of ruptured epidermal inclusion cysts in the subareolar area, which is a very unusual location for these cysts and these lesions can be mistaken for breast malignancies.

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Related in: MedlinePlus

A 44-year-old woman with periareolar pain of the left breast.A-D. The initial mediolateral oblique mammogram shows asymmetry of the left subareolar area, periareolar skin thickening and axillary lymphadenopathy (A), and the initial sonography shows a heterogeneous mass with peripherally increased vascular flow (B). About one year after medical treatment, the mass disappeared on sonography with a remaining Ill defined low echoic subareolar portion (C). The discrete subareolar mass was again noted seven months later on sonography when she revisited the hospital with a heat sensation and tenderness (D).
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Figure 2: A 44-year-old woman with periareolar pain of the left breast.A-D. The initial mediolateral oblique mammogram shows asymmetry of the left subareolar area, periareolar skin thickening and axillary lymphadenopathy (A), and the initial sonography shows a heterogeneous mass with peripherally increased vascular flow (B). About one year after medical treatment, the mass disappeared on sonography with a remaining Ill defined low echoic subareolar portion (C). The discrete subareolar mass was again noted seven months later on sonography when she revisited the hospital with a heat sensation and tenderness (D).

Mentions: A 44-year-old woman presented with left periareolar pain for several months. Mammography revealed left subareolar asymmetry, periareolar skin thickening and axillary lymph node hypertrophy (Fig. 2A). Sonography shows a 2.2×1.7-cm ill defined mass with an irregular shape, heterogeneous echogenicity and posterior enhancement (Fig. 2B). FNAB was performed to differentiate this from inflammatory breast cancer, but malignant cells were not found. The symptoms were improved after administering antibiotics, and we formed a clinical impression of breast abscess. One year later, the patient presented again with yellowish discharge of the left nipple. On the follow up mammogram, the density of the left subareolar asymmetry and skin thickening was decreased, but it was still observed, and no significant change was observed in the left axillary lymph nodes. On sonography, the previously observed mass showed decreased size (1.5×1.5-cm) and echogenicity. One month after antibiotic administration, the mass disappeared and an irregularly shaped hypoechogenicity was seen on the follow-up sonogram (Fig. 2C). About seven months later, the patient presented with a heat sensation and pain on the same area. The previous hypoechogenicity area changed to a 1.1×0.8-cm mass on sonography and a recurrent abscess was suspected (Fig. 2D). The mass was excised and pathologically confirmed as a ruptured epidermal inclusion cyst.


Ruptured epidermal inclusion cysts in the subareolar area: sonographic findings in two cases.

Whang IY, Lee J, Kim JS, Kim KT, Shin OR - Korean J Radiol (2007 Jul-Aug)

A 44-year-old woman with periareolar pain of the left breast.A-D. The initial mediolateral oblique mammogram shows asymmetry of the left subareolar area, periareolar skin thickening and axillary lymphadenopathy (A), and the initial sonography shows a heterogeneous mass with peripherally increased vascular flow (B). About one year after medical treatment, the mass disappeared on sonography with a remaining Ill defined low echoic subareolar portion (C). The discrete subareolar mass was again noted seven months later on sonography when she revisited the hospital with a heat sensation and tenderness (D).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2627164&req=5

Figure 2: A 44-year-old woman with periareolar pain of the left breast.A-D. The initial mediolateral oblique mammogram shows asymmetry of the left subareolar area, periareolar skin thickening and axillary lymphadenopathy (A), and the initial sonography shows a heterogeneous mass with peripherally increased vascular flow (B). About one year after medical treatment, the mass disappeared on sonography with a remaining Ill defined low echoic subareolar portion (C). The discrete subareolar mass was again noted seven months later on sonography when she revisited the hospital with a heat sensation and tenderness (D).
Mentions: A 44-year-old woman presented with left periareolar pain for several months. Mammography revealed left subareolar asymmetry, periareolar skin thickening and axillary lymph node hypertrophy (Fig. 2A). Sonography shows a 2.2×1.7-cm ill defined mass with an irregular shape, heterogeneous echogenicity and posterior enhancement (Fig. 2B). FNAB was performed to differentiate this from inflammatory breast cancer, but malignant cells were not found. The symptoms were improved after administering antibiotics, and we formed a clinical impression of breast abscess. One year later, the patient presented again with yellowish discharge of the left nipple. On the follow up mammogram, the density of the left subareolar asymmetry and skin thickening was decreased, but it was still observed, and no significant change was observed in the left axillary lymph nodes. On sonography, the previously observed mass showed decreased size (1.5×1.5-cm) and echogenicity. One month after antibiotic administration, the mass disappeared and an irregularly shaped hypoechogenicity was seen on the follow-up sonogram (Fig. 2C). About seven months later, the patient presented with a heat sensation and pain on the same area. The previous hypoechogenicity area changed to a 1.1×0.8-cm mass on sonography and a recurrent abscess was suspected (Fig. 2D). The mass was excised and pathologically confirmed as a ruptured epidermal inclusion cyst.

Bottom Line: Epidermal inclusion cyst of the breast is an uncommon benign lesion and it is usually located in the skin layer.We report here on two cases of ruptured epidermal inclusion cysts in the subareolar area, which is a very unusual location for these cysts and these lesions can be mistaken for breast malignancies.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Uijongbu St. Mary's Hospital, Catholic University College of Medicine, Kyunggido 480-717, Korea. tiger@catholic.ac.kr

ABSTRACT
Epidermal inclusion cyst of the breast is an uncommon benign lesion and it is usually located in the skin layer. We report here on two cases of ruptured epidermal inclusion cysts in the subareolar area, which is a very unusual location for these cysts and these lesions can be mistaken for breast malignancies.

Show MeSH
Related in: MedlinePlus