Tuberculous mastitis simulating carcinoma of the breast in a young Nigerian woman: a case report

Abstract

Tuberculous mastitis is an uncommon disease even in countries where tuberculosis is highly endemic. It typically presents a diagnostic challenge masquerading as carcinoma or other primary disease of the breast. We report the case of a young multiparous Nigerian woman who presented with a tender left breast lump and enlargement of the left axillary lymph nodes for which a provisional diagnosis of carcinoma of the breast was made after clinical and radiological evaluation. The mass was pathologically diagnosed as tuberculous mastitis and anti-tuberculous therapy was instituted although she later absconded. This case shows that TM may present a diagnostic challenge on clinical, radiologic and microbiological investigation. Therefore, a high index of suspicion as well as FNAC and/or histological evaluation of tissue samples remain very important its diagnosis.

Keywords: Nigerian woman; Tuberculous mastitis; breast carcinoma; mimic.

Figure 1

Low power view showing a few granulomas with central caseous necrosis and thin peripheral rim of lymphocytes. Normal breast glands showing pregnancy-associated changes can be seen at the upper edges of the photomicrograph (H&E, X80)

Figure 2

Higher power view shows one of the granulomas with an obvious central area of caseous necrosis surrounded by epithelioid cells among which are seen a few multinucleated giant cells. Normal breast glands with pregnancy-like changes are seen at the upper end of the micrograph (H&E, X200)