A case of diabetic mastopathy with multiple lesions mimicking breast cancer

Abstract

We report a case of diabetic mastopathy with multiple unilateral lesions in an insulin dependent patient. The patient was a 62-year-old woman with two hard tumors in the right breast, who had been treated with insulin for diabetes mellitus. Mammography revealed a highly dense tumor in the right breast, while ultrasonography showed two irregular hypoechoic lesions with marked posterior acoustical shadowing, suggesting scirrhous carcinoma. On magnetic resonance imaging the two lesions had slightly heterogeneous enhancement. Aspiration breast cytology showed insufficient cellular material for evaluation. Excisional biopsy was performed because the patient wanted confirmation and treatment. Fibrosis with dense lymphocytic infiltration around the lobules and ducts was diagnosed histopathologically. These findings were compatible with diabetic fibrous mastopathy. Although this disease is thought to be a diabetes-induced reaction of autoimmune origin, multiple lesions are rare. This is the first case of unilateral multiple lesions of diabetic mastopathy.

An Uncommon Case of Diabetic Mastopathy in Type II Non-Insulin Dependent Diabetes Mellitus

“…Diabetic mastopathy is an uncommon tumorlike proliferation of fibrous tissue of the breast, mimicking breast cancer clinically 8,14,15) , and usually occurs in patients with type diabetes mellitus of long duration. Since Soler and Khardori first reported 2 cases of fibrous disease of the breast in association with longstanding type 1 diabetes mellitus in 1984 16) , 168 cases of diabetic mastopathy that occurred in patients with type diabetes mellitus have been reported in 29 papers so far 1-8, 10, 12-31) .…”

“…These appearances are nonspecific and mimic those of scirrhous or invasive lobular carcinoma 19,20,33) . MR imaging findings, although there are only a few reports, vary from no enhancement to slight heterogeneous enhancement of the mass 10,11,13,14) . In our case, MR imaging revealed a blurred contrast enhanced area, which is not typical of malignancy, but malignancy could not be excluded.…”

“…Here we report an unusual case of diabetic mastopathy in a type non insulin dependent patient. In this report, we also review MR findings that have been described in the literature 10,11,13,14) .…”

Diabetic Mastopathy of Bilateral Breasts in an Elderly Japanese Woman with Type 2 Diabetes: A Case Report and a Review of the Literature in Japan

“…; DMP is a rare disease in Japanese (9)(10)(11)(12)(13)(14)(15). DMP clinically mimics breast cancer and it is also reported that mastectomy has been performed because it was misinterpreted as breast cancer (7,16 (Fig.…”

Diabetic mastopathy: a case report

“…1,2 At the time of presentation with breast symptoms, patients often have associated complications of DM such as retinopathy, nephropathy, and neuropathy. 3,4 Histologically, it consists of lymphocytic mastitis and stromal fibrosis. 1,3,4,5 Most published reports on DMP are on premenopausal women with long-standing type 1 DM.…”