A large epidermoid cyst of breast mimicking carcinoma: A case report and review of literature

Abstract

Diagnostic dilemma while dealing with a suspected breast cancer is not rare. Involvement of multidisciplinary team as well as patient is important in the decision-making. The report illustrates a rare presentation of a deep seated large epidermoid cyst of breast, which mimicked carcinoma, caused diagnostic confusion and entailed mastectomy. We strongly advocate the option of breast reconstruction in such cases.

Ruptured Epidermal Inclusion Cyst of the Breast

“…To our knowledge this is the first reported case of a patient with non-bloody nipple discharge as the first presenting complaint of an epidermal inclusion cyst. The most common cyst location reported, including the case presented here, is in the sub-areolar region [3,4,6,[14][15][16]. These cysts are composed of stratified squamous epithelium filled with lamellated keratin, occasionally with calcifications [2].…”

“…However, very few are found in the breast [1][2][3][4][5]. To date, approximately 40 have been reported in the literature [3,4,[6][7][8][9][10][12][13][14][15][16][17]. Most that have been reported presented with a palpable mass in the breast [3,4,[6][7][8][9][10][14][15][16][17].…”

“…To date, approximately 40 have been reported in the literature [3,4,[6][7][8][9][10][12][13][14][15][16][17]. Most that have been reported presented with a palpable mass in the breast [3,4,[6][7][8][9][10][14][15][16][17]. Few of these cysts have presented with accompanying pain [3,4,6,12,[15][16][17]or noticeable change in size 4,8,14.…”

“…Most that have been reported presented with a palpable mass in the breast [3,4,[6][7][8][9][10][14][15][16][17]. Few of these cysts have presented with accompanying pain [3,4,6,12,[15][16][17]or noticeable change in size 4,8,14. To our knowledge this is the first reported case of a patient with non-bloody nipple discharge as the first presenting complaint of an epidermal inclusion cyst.…”

“…The pathogenesis of differentiation of an epidermal cyst into carcinoma is not completely clear. Chronic irritation or repetitive trauma to the epithelial lining of the cyst has been suggested to play a role in malignant transformation, however, this relationship has not been established [2,3,6,[14][15][16]. Epidermal inclusion cyst can potentially be serious, and fine needle aspiration or excision is usually required for differentiation from a malignant or benign breast tumor.…”