Chronic Idiopathic Granulomatous Mastitis in a Male Patient

Main Article Content

Tapanutt Likhitmaskul
Suphatcharee Aroonsiriwattana

Abstract

Idiopathic granulomatous mastitis is a rare inflammatory disease of the breast, typically occurs in reproductive age women with a history of pregnancy and breastfeeding. Furthermore, it is exceedingly rare in males. As the clinical signs and symptoms with radiological imaging of idiopathic granulomatous mastitis can imitate two common breast diseases, mastitis with abscess and inflammatory breast cancer, a tissue biopsy is required for clear diagnosis. Given the rarity and unknown etiology of the disease, an ideal treatment method has not been established. Conservative treatment with immunosuppressive therapy has proven good efficacy. However, in recurrent cases and cases unresponsive to conservative or medical treatment, the surgical options, such as surgical wide excision and/or mastectomy, should be considered. In this case report, we present a male patient diagnosed with left idiopathic granulomatous mastitis. We review and discuss the clinical presentation, imaging, diagnosis, and management of this patient that eventually was treated successfully with wide local excision.

Article Details

How to Cite
1.
Likhitmaskul T, Aroonsiriwattana S. Chronic Idiopathic Granulomatous Mastitis in a Male Patient. BKK Med J [Internet]. 2024 Feb. 29 [cited 2024 Dec. 14];20(1):33. Available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/267648
Section
Case Report

References

Kawashima K, Yamamoto S, Narui K, et al. Granulomatous mastitis in a male breast: a case report and review of literature. Clin Case Rep 2023;11:e7048. doi: 10.1002/ccr3.7048

Tuli R, O’Hara BJ, Hines J, et al. Idiopathic granulomatous mastitis masquerading as carcinoma of the breast: a case report and review of the literature. Int Semin Surg Oncol 2007;4:21. doi: 10.1186/1477-7800-4-21.

Erhan Y, Veral A, Kara E, et al. A clinicopathologic study of a rare clinical entity mimicking breast carcinoma: idiopathic granulomatous mastitis. Breast 2000;9(1):52-6. doi: 10.1054/ brst.1999.0072.

Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 1972;58(6):642-6. doi: 10.1093/ajcp/58.6.642.

Likhitmaskul T, Sukpanich R, Visutdiphat S, et al. Bilateral idiopathic granulomatous mastitis: a case report. Bangkok Med J 2014; 8:65-70

Al Manasra AR, Al-Hurani MF. Granulomatous mastitis: a rare cause of male breast lump. Case Rep Oncol 2016;9(2):516 9. doi: 10.1159/000448990.

Baslaim MM, Khayat HA, Al-Amoudi SA. Idiopathic granu lomatous mastitis: A heterogeneous disease with variable clinical presentation. World J Surg 2007;31(8):1677-81. doi: 10.1007/s00268-007-9116-1.

Akcan A, Akyildiz H, Deneme MA, et al. Granulomatous lobular mastitis: A complex diagnostic and therapeutic prob lem. World J Surg 2006;30(8):1403-9. doi: 10.1007/s00268 005-0476-0.

Rubin G, Meerkotter DA. Idiopathic granulomatous mastitis. SA J Radiol 2011;15:4-5.

Lai EC, Chan WC, Ma TK, et al. The role of conservative treatment in idiopathic granulomatous mastitis. Breast J 2005;11(6):454-6. doi: 10.1111/j.1075-122X.2005.00127.x. 11.Boufettal H, Hermas S, Noun M, et al. Mastite granulo- mateuse idiopathique bilatérale. Imagerie de la Femme 2009; 19:262-4. doi:10.1016/j.femme.2009.09.004.

Reddy KM, Meyer CE, Nakdjevani A, et al. Idiopathic granulomatous mastitis in the male breast. Breast J 2005;11(1):73. doi: 10.1111/j.1075-122X.2005.21404.x.

Bani-Hani KE, Yaghan RJ, Matalka II, et al. Idiopathic granulomatous mastitis: time to avoid unnecessary mas- tectomies. Breast J 2004;10(4):318-22. doi: 10.1111/j.1075-122X.2004.21336.x.

Garcia-Rodiguez JA, Pattullo A. Idiopathic granulomatous mastitis: a mimicking disease in a pregnant woman: a case report. BMC Res Notes 2013;6:95. doi: 10.1186/1756-0500-6-95.

Olsen ML, Dilaveri CA. Idiopathic granulomatous mastitis: a case report of breast abscess. BMJ Case Rep 2011:2011:bcr0520114271. doi: 10.1136/bcr.05.2011.4271.

Veyssiere C, Vives M, Smadia A. Difficultés diagnostiques de la tuberculose mammaire. Le problème de la mastite granulomateuse. Lille Chir 1967;22:104-9.

Raj N, Macmillan RD, Ellis IO, et al. Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology 2004;43:1055-6. doi:10.1093/rheu matology/keh246

Sam KQ, Severs FJ, Ebuoma LO, et al. Granulomatous mastitis in a transgender patient. J Radiol Case Rep 2017;11(2):16-22. doi: 10.3941/jrcr.v11i2.2934.

Yaghan RJ, Ayoub NM, Shenawi HM, et al. Idiopathic granulomatous mastitis in the male population: a clinical analysis of 13 reported cases. Breast J 2020;26(7):1481-2. doi: 10.1111/tbj.13778.

Erozgen F, Ersoy YE, Akaydin M, et al. Corticosteroid treat ment and timing of surgery in idiopathic granulomatous mastitis confusing with breast carcinoma. Breast Cancer Res Treat 2010;123(2):447-52. doi: 10.1007/s10549-010-1041-6.

Al-Khaffaf B, Knox F, Bundred NJ. Idiopathic granulomatous mastitis: a 25-year experience. J Am Coll Surg 2008;206(2):269 73. doi: 10.1016/j.jamcollsurg.2007.07.041.

Patel RA, Rodriguez M. Idiopathic granulomatous mastitis: case report and review of literature. J Gen Intern Med 2010;25(3):270-3. doi: 10.1007/s11606-009-1207-2.

Akbulut S, Yilmaz D, Bakir S. Methotrexate in the manage ment of idiopathic granulomatous mastitis: review of 108 published cases and report of four cases. Breast J 2011;17(6):661-8. doi: 10.1111/j.1524-4741.2011.01162.x.

Bouton ME, Jayaram L, O’Neill PJ, Hsu CH, Komenaka IK. Management of idiopathic granulomatous mastitis with observation. Am J Surg 2015;210(2):258-62. doi: 10.1016/j. amjsurg.2014.08.044. 38 The Bangkok Medical Journal Vol. 20, No.1; February 2024

Taylor GB, Paviour SD, Musaad S, et al. A clinicopathological review of 34 cases of inflammatory breast disease showing an association between corynebacteria infection and granulomatous mastitis. Pathology 2003;35(2):109-19.

Garcia-Rodiguez JA, Pattullo A. Idiopathic granulomatous mastitis: a mimicking disease in a pregnant woman: a case report. BMC Res Notes 2013;6:95. doi: 10.1186/1756-0500 6-95.

Wilson JP, Massoll N, Marshall J, et al. Idiopathic granulo matous mastitis: In search of a therapeutic paradigm. Am Surg 2007;73(8):798-802.

Kim J, Tymms KE, Buckingham JM. Methotrexate in the management of granulomatous mastitis. ANZ J Surg 2003;73(4):247-9. doi: 10.1046/j.1445-1433.2002.02564.x.

Asoglu O, Ozmen V, Karanlik H, et al. Feasibility of surgical management in patients with granulomatous mastitis. Breast J 2005;11(2):108-14. doi: 10.1111/j.1075-122X.2005.21576.x.

Gurleyik G, Aktekin A, Aker F, et al. Medical and surgical treatment of idiopathic granulomatous lobular mastitis: A benign inflammatory disease mimicking invasive carcinoma. J Breast Cancer 2012;15(1):119-23. doi: 10.4048/ jbc.2012.15.1.119.