Division of Clinical and Surgical Sciences, University of Edinburgh, Edinburgh, UK
Department of General Surgery, Serdang Hospital, Kajang, Selangor, Malaysia.
BMJ Case Rep. 2022 Mar 10;15(3):e246838. doi: 10.1136/bcr-2021-246838.
Axillary lumps are common clinical presentations in surgery, which have various differential diagnoses. We encountered an unusual case of an isolated axillary mass. The patient was a young woman in her 20s with a 2 year history of right axillary swelling. Clinically, the lump measured 3 cm ×3 cm, mobile, non-tender, and there was no associated breast lump or skin changes. Our initial impression was an isolated lymphadenopathy, and further workup for tuberculosis lymphadenopathy returned negative. Ultrasound demonstrated a well circumscribed oval lesion, and fine needle aspiration could only identify a benign proliferative breast tissue. As it was increasing in size and causing discomfort, we decided for an excision biopsy for both diagnostic and therapeutic reasons. Intraoperatively, the lump was noted to have well defined, smooth surface along with whitish-grey appearance. The tissue surrounding it was also removed and sent for histopathological assessment. Results confirmed our diagnosis of fibroadenoma in an ectopic breast tissue.
腋窝肿块是外科常见的临床表现,有多种鉴别诊断。我们遇到了一个不常见的孤立性腋窝肿块病例。患者是一名 20 多岁的年轻女性,右侧腋窝肿胀已有 2 年病史。临床上,肿块大小为 3cm×3cm,可移动,无触痛,没有相关的乳房肿块或皮肤改变。我们的初步印象是孤立性淋巴结病,进一步检查结核性淋巴结病的结果为阴性。超声显示边界清楚的椭圆形病变,细针抽吸仅能识别良性增生性乳腺组织。由于肿块增大并引起不适,我们决定进行切除活检,既是出于诊断目的,也是为了治疗。术中,肿块表面光滑,界限清楚,呈灰白色外观。周围的组织也被切除并送检组织病理学评估。结果证实了我们的诊断:异位乳腺组织中的纤维腺瘤。