Idiopathic granulomatous mastitis: a great imitator?

Ruiter, Annabel M.; Vegting, I.L.; Nanayakkara, Prabath W.B.

doi:10.1136/bcr.03.2010.2844

Cited by 6 publications

(7 citation statements)

References 11 publications

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“…This report identified the first adolescent female with a diagnosis of idiopathic granulomatous mastitis (IGM), which is a benign breast disease of unknown etiology. It represents 1.6% of all breast diseases [ 7 ] and is considered to be a great imitator as its clinical manifestations mimic many diseases, including sarcoidosis, tuberculosis, malignancy, and infectious organisms. In our case, we performed an extensive workup including assessment of thyroid function, vitamin D levels, antineutrophil cytoplasmic antibodies, double-stranded DNA, rheumatoid factor, antinuclear antibodies, and smooth muscle antibodies with negative/normal results, thereby ruling out autoimmune as well as endocrine causes.…”

Section: Discussionmentioning

confidence: 99%

“…Many treatment modalities have been described but have had varying degrees of success. These options include watchful waiting, surgery, systemic corticosteroids, and chemotherapeutic agents [ 2 – 7 , 10 – 18 ]. Glucocorticoid treatment is the mainstay of therapy as it has been proven to cause significant disease regression [ 21 ].…”

Section: Discussionmentioning

confidence: 99%

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Granulomatous mastitis, erythema nodosum, and polyarthritis: a case report

Laor

Fakioglu

2022

J Med Case Reports

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Background Granulomatous mastitis is a rare inflammatory disease of the breast, typically seen in woman of child-bearing age. No definitive etiology has been described. In rare instances, this condition has been reported to be associated with extramammary manifestations such as erythema nodosum and arthritis. We describe this rare condition in an adolescent female. Case presentation A 16-year-old, Hispanic female presented with right-sided painful breast swelling, polyarthritis, and erythema nodosum on bilateral shins and lower thighs. Physical examination was negative for lymphadenopathy and pulmonary, gastrointestinal, and cardiovascular findings. Ophthalmologic examination for uveitis and serologic tests for autoimmune diseases were negative. Diagnosis of idiopathic granulomatous mastitis was made by exclusion of other etiologies and conditions. Confirmation was made by histopathologic examination demonstrating noncaseating granuloma within breast lobules with neutrophils and microabscess formation. After wide local excision and a short course of trimethoprim–sulfamethoxazole, our patient was placed on naproxen and prednisone, the latter being tapered off over 3 months, with steady and complete resolution of all symptoms. Conclusion This is the first reported case of idiopathic granulomatous mastitis in a pediatric patient who also had extramammary manifestations, including erythema nodosum and polyarthritis. In this case-based review, we summarize the phenotype, risk factors, prognosis, and treatment options of this rare condition, chiefly to make the readers cognizant of such a diagnostic possibility in similar clinical presentation in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Granulomatous mastitis, erythema nodosum, and polyarthritis: a case report

Laor

Fakioglu

2022

J Med Case Reports

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“…We encourage clinicians to know this rare entity in order to have a clinical suspicion and follow the proposed algorithm for correct diagnosis and treatment (Figure 4). [20][21][22][23][24]…”

Section: Discussionmentioning

confidence: 99%

Idiopathic granulomatous mastitis: a new algorithm

Priego¹,

Pedroso-Rea²,

Mancera-Resendiz³

et al. 2019

OGIJ

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Idiopathic granulomatous mastitis (IGM) is a breast non-systemic and chronic inflammatory disease that mimics abscesses, mastitis or breast cancer of low incidence, with much controversy on its diagnosis and successful treatment. The aim of this study is to retrospectively associate in an integral manner, the clinical characteristics, and the radiologic findings in order to develop an algorithm to make diagnosis and treatment of this entity easy. A retrospective analysis was performed with 16 patients for whom histologically IGM diagnoses were confirmed and were treated in our center between January 2011 and December 2016. Clinical characteristics, radiological, and histological reports, as well as treatment regime and outcome were included in the analysis.Idiopathic granulomatous mastitis is a breast-limited entity, with a chronic and generally benign course, with unknown etiology; but if not treated correctly there is a possibility of recurrence. Radiologic protocols are not sufficiently precise to establish a differential diagnosis, and while histopathological diagnosis is obligatory.Clinical treatment guides must be developed for which we strongly recommend the following diagnosis and treatment algorithm for patients with granulomatous mastitis.

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“…The NAA is usually recommended when the smear evaluation is negative for AFB, and when clinical suspicion is very high, or when TB is endemic, but there are controversies on the specificity, sensitivity of the methods regarding the origin of specimen from respiratory tract or other sites [88]. The recommended tests are the enhanced MbT Direct Test (E-MTD; Gen-Probe, San Diego, CA) and Amplicor MbT Test (Amplicor; Roche Diagnostic Systems, Inc., Branchburg, NJ), and associated to these tests there were many studies about each value, specially for differential to granulomatous mastitis [12,83,89] or for the value of polymerase chain reaction (PCR) for real time MbT to compare to formalin-fixed, paraffinembedded histologic specimens [90].…”

Section: Bacteriological Diagnosis Of Breast Tuberculosismentioning

confidence: 99%

“…"Granulomatous mastitis" was the first diagnosis in authors' mind at the beginning of investigations, and this is partially an explanation of the delay in diagnosis, and late specific antitubercular treatment, as in other cases from literature in the last years [12]. These breast pathologiestuberculosis and "idiopathic" granulomatous mastitis are considered "masquerader" [28] or "imitator" [89].…”

Section: Pathological Diagnosis In Breast Mbt Infectionmentioning

confidence: 99%

Breast and Cervix Uteri: Rare Locations for Mycobacterium Tuberculosis Infections and Complications-Cases Report and Literature Review

Russu¹,

Nastasia²,

Degeratu³

et al. 2018

Tuberculosis

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Breast and cervix uteri are rare locations for Mycobacterium tuberculosis (MbT) infection and MbT association to cervical cancer is more rare in European countries. This chapter analyses two cases of rare locations of tuberculosis (TB) in young Romanian women. The first patient presented a chronic primary TB breast abscess, non-pregnancy related with periods of apparent healing and repeated areolar fistula formation. In the second case, the unexpected discovery of secondary TB endocervical granulomatous inflammation with caseous necrosis on a radical hysterectomy specimen, performed after chemoradiotherapy for squamous nonkeratinizing cell carcinoma is presented. Worldwide incidence, risk factors, hypothetic mechanisms of primary/secondary breast and cervix uteri MbT infection, the association to highrisk HPV, microbiological diagnosis difficulties, the differentials to pyogenic abscesses, other chronic granulomas and breast cancer treatment issues are presented in the reviewed literature, focusing on the peculiarities of these rare locations and complications. It is recalled an old concept of "therapeutic antitubercular" test when all other assessments steps are usefulness.

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Idiopathic granulomatous mastitis: a great imitator?

Cited by 6 publications

References 11 publications

Granulomatous mastitis, erythema nodosum, and polyarthritis: a case report

Granulomatous mastitis, erythema nodosum, and polyarthritis: a case report

Idiopathic granulomatous mastitis: a new algorithm

Breast and Cervix Uteri: Rare Locations for Mycobacterium Tuberculosis Infections and Complications-Cases Report and Literature Review

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