Surgical resection for persistent seroma, following modified radical mastectomy

Abstract

Background: Seroma formation following modified radical mastectomy with axillary lymph node dissection for breast cancer is a most common wound complication. In our experience seroma occurs in approximately 50% of patients undergoing mastectomy. Postmastectomy seromas usually vanishes within a few weeks after operation.

Case presentation: In this report we present the case of a 73 year old woman who had undergone mastectomy with axillary lymph node dissection for breast cancer, complicated by lymphorrhea and formation fibrous encapsulated seroma resistant to conservative treatment which required surgical resection.

Conclusion: We stand in opinion that in some cases of prolonged seromatous effusion with confirmed formation of thick walled reservoir the operation with resection and closure of supplying regional lymph vessels may be the best treatment, if possible preceded by arm lymphoscyntygraphy.

Figure 1

The spindle-like serous pouch located in the subcutaneus tissue on the greater pectoral muscle, arrow indicate vessel like structure penetrating deep in to posterior site of axilla.

Figure 2

The seroma wall stained with hematoxylin/eosin under 100× magnification. Arrows indicate seroma capsule composed of fibrous tissue with eosinophilic hyaline degeneration of collagen and weak inflammatory, predominantly lymphocytic, infiltration. No epithelium was present on the inner surface of the seroma capsule.