Mazlan Luqman, Suhaimi Shahrun Niza Abdullah, Jasmin Saladina Jaszle, Latar Nani Harlina Md, Adzman Sellymiah, Muhammad Rohaizak
Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latiff, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia.
Malays J Med Sci. 2012 Apr;19(2):82-5.
Chronic granulomatous mastitis is known as a benign and relatively rare disorder that is often difficult to differentiate from breast carcinoma. We highlight the case of a 34-year-old woman who had recurrent episodes of right breast swelling and abscess for 8 years. These were proven to be chronic granulomatous mastitis by tissue biopsies on 3 different occasions. Her condition improved on similar courses of antibiotics and high-dose prednisolone. However, she subsequently developed progressive loss of vision due to an orbital tumour. She then underwent a craniotomy and left orbital decompression with excision of the tumour, which proved to be a metastatic carcinoma. A trucut biopsy of the right breast was then done and showed features consistent with an infiltrating ductal carcinoma. This case illustrates the possibility that chronic granulomatous mastitis could be a precursor for malignancy and the difficulty in differentiating one from the other. The possible mechanisms of development and the implications for future management are also discussed.
慢性肉芽肿性乳腺炎是一种良性且相对罕见的疾病,通常难以与乳腺癌相鉴别。我们着重介绍一位34岁女性的病例,她右乳反复肿胀和脓肿发作长达8年。经3次不同时机的组织活检,证实为慢性肉芽肿性乳腺炎。她在接受类似疗程的抗生素和大剂量泼尼松龙治疗后病情有所改善。然而,她随后因眼眶肿瘤出现进行性视力丧失。之后她接受了开颅手术和左眼眶减压并切除肿瘤,结果证实为转移性癌。随后对右乳进行了粗针活检,显示出与浸润性导管癌一致的特征。该病例说明了慢性肉芽肿性乳腺炎可能是恶性肿瘤的前驱病变,以及两者鉴别诊断的困难。还讨论了其可能的发病机制及对未来治疗的启示。