Presentation
Palpable, non-painful nodule with progressive growth of three months in the right breast. The patient no presented inflammatory skin changes on physical examination.
Patient Data
Right breast retroareolar, oval, circumscribed, high-density nodule with subtle areolar retraction, not associated with calcifications.
Left mediolateral oblique view does not show nodules or architectural distortions.
Retroareolar oval nodule, antiparallel to the skin plane, circumscribed, hypoechoic with delicate echoes inside and mixed posterior acoustic changes.
Case Discussion
Breast abscesses are rare benign entities in men. They can occur in all age groups. Their clinical characteristics include usually painful nodules, with inflammatory skin changes such as edema and erythema. They can be accompanied by purulent discharge from the nipple and palpable axillary lymphadenopathy. On mammography, it is visualized as a retroareolar or eccentric nodule, oval, rounded or rarely irregular, iso or hyperdense, and circumscribed 1,2. In addition to the above, nipple retraction and skin thickening can be observed. On ultrasound, it is observed as an oval, rounded or irregular nodule, parallel or antiparallel to the cutaneous plane, hypoechoic or complex cystic, with peripheral vascularity on color Doppler. It can be associated with thickening of the skin 1-3. Because imaging findings between abscesses and breast cancer in men commonly overlap, a biopsy is required to rule out malignancy 1,3.
The patient in our case, due to his clinical characteristics and imaging findings, was classified as BIRADS 4C according to the American College of Radiology 4. A Trucut biopsy was performed, with histopathological results of fibro-fatty tissue with intense suppurative chronic inflammation and foci of necrosis, fat data are compatible with abscess.
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