Epidermal inclusion cyst in breast: Is it so rare?

Abstract

Background:Epidermal inclusion cyst in the breast (EICB) is very rare. It presents as breast lump mainly in peri-areolar region and needs to be differentiated from other breast lesions with predominance of squamous cells.Aim:To analyze the role of fine needle aspiration cytology (FNAC) in patients presenting with breast lump.Materials and Methods:The present study is a retrospective study over the period of past 2 years, where the patients presented with firm breast lumps. Six of these cases were diagnosed as EICB on FNAC. Smears from these cases were reviewed for cytomorphological findings and correlated with clinico-radiological details.Results:Patients ranged in age from 25 to 60 years, and female to male sex ratio was 2:1 (female 4, male 2). Mammography was done in women (4), which showed solid, well-defined mass lesions in peri-areolar region and were suggestive of benign breast lesions (3) and infective lesion (1). FNA was performed; Giemsa-stained smears showed predominantly mature benign squamous cell and anucleated squames in all cases, thus one of the cytological diagnoses was EICB. Five of these cases had histological confirmation.Conclusion:EIC of breast is not that rare lesion as considered. The patients may not seek medical attention because of small painless swelling; unless the lump increases in size or becomes painful. FNAC is confirmatory in the presence of a typical pultaceous aspirate and cytomorphological features of EIC. Thus, FNAC plays a crucial role in its diagnosis and management. Symptomatic cases should be readily excised and need histological correlation to rule out any potential complications that can arise in these cysts.

Pattern of palpable breast lesions on fine needle aspiration: A retrospective analysis of 902 cases

“…They remain underreported because of their insignificant clinical presentation. [ 32 33 34 ] FNA smears showed numerous anucleate and nucleated benign squamous cells. Imaging can follow asymptomatic lesions.…”

Dermatofibrosarcoma Protuberans; Case Report of a Rare Tumor of the Breast

“…US in the present case showed a well-defined cyst with thick wall, internal echo septa and high vascularity, which was suspicious of malignancy or complicated cysts such as infected EIC or complex cyst. EIC is an epidermal cells growth surrounded by the dermis which could be developed anywhere in the body, often near the hair follicles in the skin, and rarely at the breast skin [16]. EIC could be caused by several triggers including congenital, metaplastic or inflammatory factors, or posttraumatic growth of epidermal elements in the cutaneous and subcutaneous tissues as a result of implantation of the epidermal cells.…”

Cytological diagnosis of epidermal inclusion cyst of breast: A rare benign lesion

“…[2] Other rare but important complication of EIC includes malignant transformation into squamous cell carcinoma. The reported malignant transformation of the cyst wall varies from 0.045% to 19%.…”