Blastomycosis of the breast

Eq, Seymour

doi:10.2214/ajr.139.4.822

Cited by 19 publications

(4 citation statements)

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“…Among fungal infections, actinomycosis has been described as a lobulated mass with irregular borders with skin thickening closely mimicking malignancy (47). Blastomycosis manifests as a partially circumscribed subcutaneous mass or bilateral masses with well-defined contours at mammography and a complex cystic structure at US (48,49).…”

Section: Specific Infectionsmentioning

confidence: 99%

Radiologic Evaluation of Uncommon Inflammatory and Reactive Breast Disorders

Sabaté¹,

Clotet²,

Gómez³

et al. 2005

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The radiologic features of breast lesions caused by immunologic, reactive, and noncurrent infectious diseases often mimic those of malignancy, frequently constituting a diagnostic challenge even if the underlying disease is known. Churg-Strauss syndrome mimics carcinomatous mastitis. Amyloidosis usually manifests as a suspicious mass, often accompanied by microcalcifications. Wegener granulomatosis and sarcoidosis often manifest as irregular masses, although sarcoidosis can also manifest as round, well-defined masses reflecting intramammary node involvement. Diabetic mastopathy is a rare but well-known entity in patients with long-standing insulin-dependent diabetes. Breast involvement by necrobiotic xanthogranulomatosis is rare and manifests as multiple bilateral asymmetric lesions. Multiple clustered hypoechoic tubular structures in a large hypoechoic mass seen after pregnancy can be suggestive of granulomatous mastitis. Mammary tuberculosis can manifest with a nodular, diffuse, or sclerosing pattern. A granulomatous inflammatory reaction must be carefully evaluated because it constitutes the major feature of a diverse group of diseases that includes vasculitis, granulomatous mastitis, tuberculosis, and carcinoma-associated sarcoidlike reactions. Core biopsy can play a major role in developing a differential diagnosis for these rare immunologic, inflammatory, or infectious disorders affecting the breast, and knowledge of these entities can, in the appropriate clinical setting, help the radiologist narrow the differential diagnosis, although cancer must be excluded definitively.

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Section: Specific Infectionsmentioning

confidence: 99%

Radiologic Evaluation of Uncommon Inflammatory and Reactive Breast Disorders

Sabaté¹,

Clotet²,

Gómez³

et al. 2005

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112

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“…5 Blastomycosis of the breast has been reported rarely in the literature (fewer than 10 cases reported in the past 50 years). [14][15][16][17] Most cases describe either a primary pulmonary route of infection or an unclear mechanism of infection, as seen in our patient.…”

Section: Clinical Featuresmentioning

confidence: 61%

A breast mass in a 56-year-old man

MacFadden¹,

Gold²,

Richardson³

et al. 2011

Canadian Medical Association Journal

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A 56-year-old man living in Toronto, Ontario, presented to his family physician after finding a lump in his right breast on self-inspection. He described a onemonth history of pressure and tenderness at the site of the mass. No other lumps were detected, and there was no history of fever, sweats, weight loss or previous trauma to the breast. He had a history of obstructive sleep apnea, took no medications and did not use recreational or injection drugs. The patient had no relevant family history and no contacts with people who were ill. His history of travel was limited to his cottage in central Ontario.On examination, a 3-cm mass that extended medially was palpable in the retroareolar area of the patient's right breast. The mass was rubbery, nontender and did not appear to be tethered to the overlying skin, which was intact. No axillary lymph adenopathy was detected. The left breast and the remainder of the general examination were normal. What is the most common cause of a breast mass in a man?a. Gynecomastia b. Breast carcinoma c. Benign fibrocystic changes d. Inflammatory/infectious diseases of the breast e. Lymphoma Gynecomastia is the most common cause of combined unilateral and bilateral breast mass(es) in men (Box 1).1-4 Clinically, gynecomastia usually presents as a concentric retroareolar rubbery mass. 4 This patient's mass was atypical of gynecomastia as it extended medially in an asymmetric fashion. Given the possibility of a malignant cause, the patient was referred for further evaluation to a rapid diagnostic clinic for breast cancer.At the clinic, the patient received a mammogram, ultrasonography and a core biopsy of the mass. Mammography showed a well-defined 2.5-cm mass located within the right breast (Figure 1). No calcifications were present. Ultrasonography confirmed these findings and did not detect any substantial regional lymphadenopathy. A core biopsy and tissue staining suggested a fungal cause (Figure 2 and Appendix 1, available at www.cmaj .ca /lookup /suppl /doi :10 .1503 /cmaj .110953/-/DC1.), but no specimen was sent for culture. Based on the results of the biopsy, the patient was referred to an outpatient clinic for infectious diseases for further evaluation and management of the condition. What is your call?A breast mass in a 56-year-old man

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“…Blastomycosis mimics several diseases and can be easily misdiagnosed as neoplasia, pyogenic gangrenosum, nocardiosis, mycobacterial infection, immunologic skin disorders, and other mycoses [4]. In the spectrum of the presentation of blastomycosis, breast involvement is uncommon, as noted in the literature [5][6][7][8][9].…”

Section: Discussionmentioning

confidence: 99%

“…The most common clinical presentation of blastomycosis is pneumonia though pulmonary infiltrates may be found on routine chest radiographs of patients with blastomycosis despite a lack of respiratory complaints [6,8]. Cutaneous involvement is the next most common clinical presentation [6].…”

Section: Discussionmentioning

confidence: 99%

Cutaneous Blastomycosis Mimicking Breast Malignancy

Chisenga

Chatterjee

Erbowor-Becksen

et al. 2021

Cureus

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Blastomycosis is a fungal infection caused by Blastomyces dermatitidis. While blastomycosis can cause systemic infection affecting multiple organs, localized blastomycosis of the breast is uncommon. Here, we report the case of a 50-year-old female with a localized left breast growth which started as a nodule and later ulcerated extensively. Although her clinical picture raised concerns for breast malignancy, workup revealed cutaneous blastomycosis with superimposed methicillin-susceptible Staphylococcus aureus and Klebsiella oxytoca infection. Interestingly, there was no evidence of pulmonary disease on CT chest imaging. She was treated with Amphotericin B for seven days and discharged on oral Itraconazole for nine months. Additionally, she received amoxicillin-clavulanate for her bacterial superinfection. On the six-month followup, the patient showed significant improvement. Blastomycosis can mimic several diseases including malignancy, pyoderma gangrenosum, and mycobacterial and bacterial infections leading to delayed diagnosis and treatment.

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Blastomycosis of the breast

Cited by 19 publications

References 0 publications

Radiologic Evaluation of Uncommon Inflammatory and Reactive Breast Disorders

Radiologic Evaluation of Uncommon Inflammatory and Reactive Breast Disorders

A breast mass in a 56-year-old man

Cutaneous Blastomycosis Mimicking Breast Malignancy

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