Abdominal masses have always been a dilemma for the surgeons and this problem is more so in retroperitoneal masses. In our case, the patient presented with retroperitoneal mass in the left lumbar region with no other specific local or systemic symptoms. The diagnosis of Castleman's disease was established only after histopathological examination of the mass after resection. Castleman's disease is an angiofollicular lymph node hyperplasia presenting either as a localized or a systemic disease. In our case, the patient presented with the localized form of the disease and as it is a rare presentation we are presenting this case.
INTRODUCTIONMastalgia, or breast pain, is a common complaint that may affect up to 70% of women in their lifetime.1 It is not unusual for women to have 2-3 days of mild breast pain premenstrually but 8-30% of women report moderate to severe breast pain with duration of 5 or more days each month.2 Fifteen percent of women who present to a breast clinic with mastalgia will require treatment.
3Breast pain is classified as cyclical mastalgia, noncyclical mastalgia and non-specific extra-mammary pain. Cyclical mastalgia is a breast pain that has clear relationship to the menstrual cycle. Non-cyclical
ABSTRACT
Background:The aim of the present study is to observe the clinical profile and management of mastalgia. The objectives of the present study were to assess the clinical profile of breast diseases causing mastalgia, to study the response of mastalgia to the following three drugs: Danazol, Bromocriptine, topical non-steroidal anti-inflammatory drugs (topical diclofenac gel). Methods: It was prospective type of study. Inclusion criteria: Patients of age group 15-50 years, all patients suspected or diagnosed for breast pathology with mastalgia. Exclusion criteria: immune-compromised patients, all patients undergoing surgical removal of breast lump, pregnant females. Evaluation of pain was done using visual analog scale, prior to giving the treatment and after giving the treatment each week for the first month and thereafter monthly for the next 6 months.
Results:The clinical profile of mastalgia was as follows: fibroadenosis accounting for 37 (46.25%), followed by 10 (12.5%) cases of fibroadenoma, 08 (10%) cases of mastitis, 06 (7.5%) cases of breast abscess, 03 (3.75%) cases of duct ectasia, 02 (2.50%) cases of galactocoele, 02 (2.50%) cases of breast carcinoma and 12 (15%) cases of nonspecific extra-mammary pathology. Patient's response rate to different drugs included in the study was: 64.8% to danazol, 56.9% to bromocriptine and 76.01% to topical diclofenac gel. Conclusions: Cyclical mastalgia accounted for more proportion of patients than non-cyclical mastalgia. Common causes of mastalgia being fibroadenosis, followed by fibroadenoma, mastitis, breast abscess, duct ectasia, galactocoele, breast carcinoma and non-specific extra-mammary pathology. Danazol and bromocriptine are effective in treatment of mastalgia, though they show different side effect profiles and varying patient compliance.
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