Bilateral Axillary Accessory Breast Tissue Revealed by Pregnancy

Abstract

Rezumat Åesut mamar accesor axilar bilateral evidenåiat de sarcinãIlustrãm cazul rar al unei paciente de 28 ani ce s-a prezentat cu douã formaåiuni tumorale axilare bilateral ce au apãrut în timpul sarcinii, crescând apoi progresiv în dimensiuni. Examenul local a evidenåiat douã formaåiuni de 5/3/5 cm fiecare cu caracteristici clinice de benignitate, dezvoltate la nivelul extensiei axilare a glandei mamare. În timpul lactaåiei, un lichid similar laptelui s-a evacuat printr-un mamelon rudimetar, maroniu, localizat în centrul fiecãrei formaåiuni. La 1 an de la naaetere, rezonanåa magneticã nuclearã e evidenåiat la nivelul celor douã mase tumoraleåesut mamar accesor cu acelaaei semnal ca aei glanda eutopicã de care se delimiteazã. Din motive estetice aei din cauza riscului de a dezvolta tumori benigne sau maligne, åesutul mamar ectopic a fost excizat chirurgical. Examenul histologic a evidenåiat åesut mamar glandular normal.Cuvinte cheie: åesut mamar accesor, polimastie, axilã, sarcinã Abstract We illustrate a rare case of a 28 year-old woman with bilateral axillary masses, which were uncovered during her first pregnancy only and grew progresively in size ever since. On local examination, there were two 5/3/5 cm masses with benign clinical characteristics, developed apparently on the axillary extension of the mammary gland. During lactation, a milk-like liquid was evacuated through a brownish, rudimentary, nipple located in the center of each axillary masses. One year after parturition, the MRI showed bilateral axillary breast tissue appearance, separated from the eutopic mammary gland, but having similar signal intensity. Due to aesthetic reasons and the additional risk for subsequent malignant or benign breast disease, the ectopic breast tissues were completely surgically removed. The histology report showed normal glandular breast tissue.

Ectopic axillary breast tissue appeared in pregnancy and revealed by ultrasound

“…[1] For this reason, before puberty the accessory tissue is often completely asymptomatic while after puberty, in particular during menstrual period, pregnancy or breast feeding, it usually becomes symptomatic with swelling, pain, volume increase. [1,3,6] Even an iatrogenic hormonal 5 stimulation may unmask an ectopic breast tissue, as we reported in a patient affected by complete androgen insensitivity syndrome [7].…”

“…In normal breast development, the mammary ridges regress, except for two small portions in the pectoral region. If the regression is incomplete, the aberrant tissue will lead to ectopic breast tissue [3,4].…”

“…In comparison, ABT only consists in an island of breast tissue without any relationship to the overlying skin, often located very close to the normal breast position. Indeed the axilla is the most commonly involved site (bilateral or confined to the right side) [6], followed by the inframammary area [1,3,4]. When only supernumerary nipple or/and areolae are present, without any glandular tissue, the term polythelia is used [3,6].…”

“…Indeed the axilla is the most commonly involved site (bilateral or confined to the right side) [6], followed by the inframammary area [1,3,4]. When only supernumerary nipple or/and areolae are present, without any glandular tissue, the term polythelia is used [3,6].…”

“…Once diagnosis of ectopic breast tissue is made, periodical screening is mandatory, exactly as normal breasts. [3,5] The surgical option is not always necessary and is often a cosmetic choice [1], therefore our patient chose to be followed sonographically every six months. This document is protected by international copyright laws.…”