Military Medical Academy, Sofia, Bulgaria.
St Ivan Rilski University Hospital, Medical University, Sofia, Bulgaria.
Folia Med (Plovdiv). 2020 Mar 31;62(1):23-30. doi: 10.3897/folmed.62.e47740.
Although the liver and lung are the most frequently affected organs in cystic echinococcosis, the cysts may develop in any viscera and tissues. Breast is a rare primary localization with few cases described in the literature. We present an updated and systematic review and discuss the possible mechanisms of spreading, diagnostic and treatment options.
We performed a literature search in PUBMED using the key words ‘hydatid disease’, ‘cystic echinococcosis’ and ‘breast echinococcosis’ without time limitation. Only studies reporting breast cystic echinococcosis were included.
Overall, 121 cases with cystic echinococcosis and 2 with alveolar echinococcosis were reported. A total of 52 cases were included in the analysis. The mean size of cysts was 5.5 cm (range 1.7-12). The most common clinical presentation was painless lump presented from 4 months to 19 years before the final diagnosis. Most cases had isolated breast CE, few cases had synchronous localizations – femoral, thigh and lung, and previous liver CE. Most were active CL and CE1-2 cysts (72%). Ultrasound was used in 83%, followed by mammography (35%). Fine needle aspiration was reported in 27 cases with positive finding in 59%.
In cases with cystic breast lesions from endemic regions we recommend the US as a gold standard. CT and MRT are more accurate but expensive tools without the potential to change the surgical tactic. In contrast to the other localizations of CE, complete excision of the cysts is the best diagnostic and treatment approach.
尽管肝和肺是囊型包虫病最常累及的器官，但包虫囊肿也可能发生在任何内脏器官和组织中。乳腺是一种罕见的原发部位，文献中仅有少数病例报道。我们对其进行了更新和系统的回顾，并讨论了可能的传播机制、诊断和治疗选择。
我们在 PUBMED 数据库中使用“hydatid disease”“cystic echinococcosis”和“breast echinococcosis”等关键词进行了无时间限制的文献检索。仅纳入了报道乳腺囊型包虫病的研究。
共报道了 121 例囊型包虫病和 2 例泡型包虫病患者，其中 52 例纳入分析。囊肿的平均大小为 5.5cm（范围 1.7-12cm）。最常见的临床表现为无痛性肿块，在最终诊断前 4 个月至 19 年间出现。大多数病例为孤立性乳腺 CE，少数病例存在同侧局部病变（股骨、大腿和肺部）和既往肝 CE。大多数为活动性 CL 和 CE1-2 囊肿（72%）。83%的病例使用了超声，35%的病例使用了乳腺 X 线摄影术。27 例行细针抽吸活检，阳性率为 59%。
对于来自流行地区的囊性乳腺病变，我们建议使用超声作为金标准。CT 和 MRT 更准确，但价格昂贵，且无改变手术策略的潜力。与 CE 的其他部位不同，囊肿的完全切除是最好的诊断和治疗方法。
