Cyclosporine-A therapy-induced multiple bilateral breast and accessory axillary breast fibroadenomas: a case report

Darwish, Ahmed A.; Nasr, Ayman; Hassan, Lamya A El; Fahal, Ahmed H.

doi:10.1186/1752-1947-4-267

Cited by 10 publications

(7 citation statements)

References 6 publications

(9 reference statements)

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“…Their patient had undergone surgical excision for multiple bilateral breast and axillary fibroadenomas (13). Discontinuing the CsA may induce some improvement in early cases, but the breast may not return to its former size due to breast fibrosis, as in our patient (14).…”

Section: Case Reportmentioning

confidence: 94%

Irreversible Unilateral Gynecomastia in a Cadaveric Kidney Transplant Recipient

2015

Turk Neph Dial Transpl

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Gynecomastia (GM) is a benign condition characterized by enlargement of the male breast, which is attributed to proliferation of the glandular tissue and local fat deposition. We present here a case with unilateral GM that gradually developed after cadaveric renal transplantation.A 37-year-old man who underwent renal transplantation in 2010 was admitted to our center with complaints of unilateral right-sided GM. There was no nipple discharge, pain or redness in the affected breast. His graft was functioning well. His medications consisted of Cyclosporine (CsA) at a dose of 200 mg/d, mycophenolic acid at a dose of 2000 mg/d, prednisolone at a dose of 5 mg/d, doxazosin 8 mg/d, and metoprolol 50 mg/d. CsA-induced GM was considered, and CsA was switched to sirolimus. After two months, GM regression was not observed. Fine needle aspiration of a right breast mass revealed a benign condition. Estrogen and progesterone receptor was strongly positive on microscopic examination of the tissue. GM is a rare condition that is generally caused by CsA treatment. However, GM may persist after the discontinuation of CsA. Key worDs: Cyclosporine A, Gynecomastia, Renal transplantation ÖzJinekomasti, bölgesel yağ birikimi ve glanduler dokunun proliferasyonunu ile olan, erkek memesinin büyümesi ile karakterize benign bir durumdur. Biz burada, kadaverik böbrek transplantasyonu sonrası gelişen tek taraflı jinekomasti olgusunu sunduk. 2010 yılında böbrek transplantasyonu olan 37 yaşında bir erkek hasta, merkezimize tek-sağ taraflı jinekomasti bulgusu ile kabul edildi. Etkilenen memede ağrı, kızarıklık, akıntı yoktu. Greft fonksiyonu iyiydi. İlaçları siklosporin 200 mg/gün, mikofenolik asit 2000 mg/gün, prednizolon 5 mg/ gün, doksazosin 8 mg/gün, metoprolol 50 mg/gün idi. Siklosporine bağlı jinekomasti düşünüldü ve siklosporin sirolimus ile değiştirildi. 2 ay sonra jinekomastide gerileme gözlenmedi. Sağ memeden yapılan ince iğne aspirasyon biopsisi benign sonuç geldi. Dokuların mikroskobik tetkikinde; östrojen ve progesteron reseptörleri güçlü pozitif geldi.Kalsinörin tedavisi ile meydana gelen jinekomasti nadir bir durumdur. Fakat jinekomasti kalsinörin kesildikten sonra kalıcı olabilir.

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Section: Case Reportmentioning

confidence: 94%

Irreversible Unilateral Gynecomastia in a Cadaveric Kidney Transplant Recipient

2015

Turk Neph Dial Transpl

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“…Yarak et al [13] and Darwish et al [16] reported cases of fi broadenoma in accessory mammary tissue in kidney transplant recipients using Cyclosporine-A. This is one of the drugs that inhibits T-cell activation via calcineurin inhibition.…”

Section: Discussionmentioning

confidence: 99%

“…Consequently, there is an in increase in prolactin blood levels, suggesting infl uence in the steroidogenic function of the ovary and thus affecting the physiological state of the breast. Its chronic use could develop malignant cutaneous tumors and benign mucocutaneous proliferative diseases (fi broadenomas, hypertrichosis, gingival hypertrophy, papillomas, sebaceous hyperplasia and epidermic cysts) [13,16].…”

Section: Discussionmentioning

confidence: 99%

“…We conducted a systematic literature review regarding case reports of fi broadenoma in axilla by searching pubmed, using the following terms: "axillary breast" and "fi broadenoma" / "ectopic breast" and "fi broadenoma" / "axilla" [and] "fi broadenoma" / "supernumerary breast" and "fi broadenoma". We included all case reports of fi broadenoma in axilla with available abstract, totalizing 10 reports (Table 1) [1,4,8,9,[11][12][13][14][15][16]. The patients' average age was 33.2 years (minimum of 21 and maximum of 58 years), and the mean lesion size was 3.5 cm.…”

Section: Discussionmentioning

confidence: 99%

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Fibroadenoma of the Axilla in A Patient With Macroprolactinoma

Lages

2011

J Med Cases

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Ectopic breast tissues may be affected by to the same physiological and pathological alterations seen in the normal breast, including fi broadenoma. We report a 30-year-old nulliparous woman who presented with a left axillary lump, for which clinical impression of axillary lymphadenopathy was made. She was receiving treatment with cabergoline due to a prolactinoma with galactorrhea for some years, but her serum prolactin levels were still high. The patient underwent surgical resection of the nodule and the histology was identical to the fi broadenomas seen in the breast. To the best of our knowledge, this is the fi rst report of fi broadenoma of the axilla in a patient with a macroprolactinoma. fi broadenoma in an ectopic breast tissue must be kept in mind in the differential diagnosis of axillary mass.

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“…MF in separate quadrants have been excised by incision in the circumareolar region after stringent selection criteria,[ 4 ] or by multiple incisions placed on the breast skin directly over the lumps[ 5 ] with risk of poor esthetic outcome. They have also been removed with round block incision technique which isolates the nipple-areolar complex and by reduction mammoplasty of Rezai and which is a more extensive procedure, particularly suited for patients who have asymmetry of the breasts.…”

Section: Introductionmentioning

confidence: 99%

Circumareolar incision-subdermal tunneling dissection for excision of multiple breast fibroadenomata

et al. 2017

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Excision of multiple fibroadenomas (MF) in separate breast quadrants presents difficulties of number and location of incision(s) and extent of tissue dissection and may be associated with more complications and poorer cosmetic outcome. This is a report of excision of MF in multiple quadrants of the breast using a modification of subcutaneous dissection technique dubbed the circumareolar incision and subdermal tunneling (CAST) dissection. After exposure of the superficial fascia with circumareolar incision, subdermal cone-wise dissection was made to allow mobilization of the segment bearing the lump(s). The lump(s) were enucleated and removed. MF were removed from four breasts in three young unmarried females. The first patient had multiple adenomas removed from three quadrants of both breasts: 14 on the right and six on the left. The second patient had excision of three lumps in three separate quadrants, and the third patient had excision of two lumps in two separate quadrants. All patients had edema and bruising. One breast had wound infection and dehiscence. There were no skin necrosis, no nipple loss, and no breast distortion. All ensuing scars were camouflaged. CAST dissection was used for excision of MF in multiple quadrants of the breast with preservation of excellent cosmetic outcome of a single circumareolar incision.

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Cyclosporine-A therapy-induced multiple bilateral breast and accessory axillary breast fibroadenomas: a case report

Cited by 10 publications

References 6 publications

Irreversible Unilateral Gynecomastia in a Cadaveric Kidney Transplant Recipient

Irreversible Unilateral Gynecomastia in a Cadaveric Kidney Transplant Recipient

Fibroadenoma of the Axilla in A Patient With Macroprolactinoma

Circumareolar incision-subdermal tunneling dissection for excision of multiple breast fibroadenomata

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