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Ginecología y obstetricia de México
versão impressa ISSN 0300-9041
Resumo
SANTIAGO-SANABRIA, Leopoldo et al. Granulomatous mastitis: a cancer simulator, a great diagnostic and therapeutic challenge. Ginecol. obstet. Méx. [online]. 2022, vol.90, n.5, pp.448-455. Epub 12-Set-2022. ISSN 0300-9041. https://doi.org/10.24245/gom.v90i5.6954.
BACKGROUND:
Idiopathic granulomatous mastitis is an extremely rare benign entity of the mammary gland, simulating breast cancer. The most significant clinical manifestations are: palpable nodule, skin discoloration changes and mastalgia. The diagnosis requires the support of auxiliary imaging studies, although a biopsy is essential to establish the definitive diagnosis. There are no well-established treatment guidelines, but there are guidelines for pharmacological and surgical treatment, the latter is reserved for cases of recurrence, which are frequent.
CLINICAL CASE:
A 35-year-old nulligesta patient came for consultation due to the appearance of a palpable tumor in the right mammary gland, of 7 months of evolution, with changes in color and nipple retraction. The mastography and ultrasound catalogued the tumor in BI-RADS 5. The biopsy with cutting needle and cytology integrated the diagnosis of idiopathic granulomatous mastitis. Pharmacological treatment was indicated, and the tumor disappeared spontaneously.
CONCLUSIONS:
Granulomatous mastitis is a rare disease with a complex diagnosis. For each patient there will be a different protocol to avoid overtreatment. Its prognosis is good, despite being a breast cancer simulator. Treatment is still ambiguous but, in the first instance, corticosteroids or immunosuppressants are recommended and surgical treatment is reserved for cases of recurrence.
Palavras-chave : Granulomatous mastitis; Mammary gland; Breast cancer; Mastalgia; BI-RADS; Rare disease; Corticosteroids; Immunosupressants.