Cribriform carcinoma mimicking breast abscess – case report. Diagnostic and therapeutic management

The authors presents a case of cribriform breast carcinoma in a cyst that clinically imitated an abscess. The case concerns a 71-year-old female patient treated for ankylosing spondylitis, with a positive family history of breast cancer. The patient presented at the surgical clinic for incision of a...

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Main Authors:	Dobruch-Sobczak, Katarzyna, Roszkowska-Purska, Katarzyna, Chrapowicki, Eryk
Format:	Online
Language:	English
Published:	Medical Communications Sp. z o.o. 2013
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4613582/

id	pubmed-4613582
recordtype	oai_dc
spelling	pubmed-46135822015-12-15 Cribriform carcinoma mimicking breast abscess – case report. Diagnostic and therapeutic management Dobruch-Sobczak, Katarzyna Roszkowska-Purska, Katarzyna Chrapowicki, Eryk Case Report The authors presents a case of cribriform breast carcinoma in a cyst that clinically imitated an abscess. The case concerns a 71-year-old female patient treated for ankylosing spondylitis, with a positive family history of breast cancer. The patient presented at the surgical clinic for incision of an abscess of the mammary gland localized in the lower inner quadrant that was a consequence of previous trauma to the right breast. The abscess was incised and the serosanguineous contents were evacuated. The wound was drained and antibiotics (Dalacin with Metronidazol) were administered for the period of 10 days. During the treatment, a cutaneous fistula was formed. At the incision site, a hard thickening was palpable (tumor). Core needle biopsy of the clinically palpable tumor was performed and the purulent material from the fistula was collected for a culture test. Complete blood count did not reveal leucocytosis. In accordance with the obtained sensitivity report, the patient was started on antibiotics again. Breast ultrasound performed upon the completion of the antibiotic therapy, in the right breast, revealed two solidcystic oval lesions with thick echogenic walls and blurred margins. Both masses contained dense levels of fluid material and solid polycyclic structures. On sonoelastography, the lesions were heterogeneous with a high Young's modulus. In the right axillary fossa, ultrasound examination revealed three abnormal lymph nodes enlarged to 31 mm length, which were rounded, hypoechoic and without visible sinuses. Histopathology of the core needle biopsy performed at admittance and after the antibiotic therapy indicated a breast abscess (presence of fibrinous and partly fibrinopurulent material). The mass was finally resected to confirm histopathology. The resected material revealed the presence of an invasive, moderately differentiated cribriform carcinoma, which developed within a cyst, with a 40% necrotic component. Eighteen months after the commencement of treatment, the patient remains under oncological supervision and continues hormonal therapy. There are no signs of relapse or foci of distant metastases. The occurrence of breast carcinoma within an abscess emphasises the need for comprehensive assessment and correlation of the clinical picture with imaging and histopathological findings. It also highlights the necessity to include breast abscess in the differential diagnosis of rare forms of carcinomas. Medical Communications Sp. z o.o. 2013-06-30 2013-06 /pmc/articles/PMC4613582/ /pubmed/26674469 http://dx.doi.org/10.15557/JoU.2013.0022 Text en 2013 Polish Ultrasound Society. Published by Medical Communications Sp. z o.o. All rights reserved. http://creativecommons.org/licenses/by-nc-nd This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives License (CC BY-NC-ND). Reproduction is permitted for personal, educational, non-commercial use, provided that the original article is in whole, unmodified, and properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Dobruch-Sobczak, Katarzyna Roszkowska-Purska, Katarzyna Chrapowicki, Eryk
spellingShingle	Dobruch-Sobczak, Katarzyna Roszkowska-Purska, Katarzyna Chrapowicki, Eryk Cribriform carcinoma mimicking breast abscess – case report. Diagnostic and therapeutic management
author_facet	Dobruch-Sobczak, Katarzyna Roszkowska-Purska, Katarzyna Chrapowicki, Eryk
author_sort	Dobruch-Sobczak, Katarzyna
title	Cribriform carcinoma mimicking breast abscess – case report. Diagnostic and therapeutic management
title_short	Cribriform carcinoma mimicking breast abscess – case report. Diagnostic and therapeutic management
title_full	Cribriform carcinoma mimicking breast abscess – case report. Diagnostic and therapeutic management
title_fullStr	Cribriform carcinoma mimicking breast abscess – case report. Diagnostic and therapeutic management
title_full_unstemmed	Cribriform carcinoma mimicking breast abscess – case report. Diagnostic and therapeutic management
title_sort	cribriform carcinoma mimicking breast abscess – case report. diagnostic and therapeutic management
description	The authors presents a case of cribriform breast carcinoma in a cyst that clinically imitated an abscess. The case concerns a 71-year-old female patient treated for ankylosing spondylitis, with a positive family history of breast cancer. The patient presented at the surgical clinic for incision of an abscess of the mammary gland localized in the lower inner quadrant that was a consequence of previous trauma to the right breast. The abscess was incised and the serosanguineous contents were evacuated. The wound was drained and antibiotics (Dalacin with Metronidazol) were administered for the period of 10 days. During the treatment, a cutaneous fistula was formed. At the incision site, a hard thickening was palpable (tumor). Core needle biopsy of the clinically palpable tumor was performed and the purulent material from the fistula was collected for a culture test. Complete blood count did not reveal leucocytosis. In accordance with the obtained sensitivity report, the patient was started on antibiotics again. Breast ultrasound performed upon the completion of the antibiotic therapy, in the right breast, revealed two solidcystic oval lesions with thick echogenic walls and blurred margins. Both masses contained dense levels of fluid material and solid polycyclic structures. On sonoelastography, the lesions were heterogeneous with a high Young's modulus. In the right axillary fossa, ultrasound examination revealed three abnormal lymph nodes enlarged to 31 mm length, which were rounded, hypoechoic and without visible sinuses. Histopathology of the core needle biopsy performed at admittance and after the antibiotic therapy indicated a breast abscess (presence of fibrinous and partly fibrinopurulent material). The mass was finally resected to confirm histopathology. The resected material revealed the presence of an invasive, moderately differentiated cribriform carcinoma, which developed within a cyst, with a 40% necrotic component. Eighteen months after the commencement of treatment, the patient remains under oncological supervision and continues hormonal therapy. There are no signs of relapse or foci of distant metastases. The occurrence of breast carcinoma within an abscess emphasises the need for comprehensive assessment and correlation of the clinical picture with imaging and histopathological findings. It also highlights the necessity to include breast abscess in the differential diagnosis of rare forms of carcinomas.
publisher	Medical Communications Sp. z o.o.
publishDate	2013
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4613582/
_version_	1613490668501467136

Cribriform carcinoma mimicking breast abscess – case report. Diagnostic and therapeutic management

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