Focal necrosis mimicking breast cancer following coronary bypass grafting

World Journal of Surgical Oncology

Case Report

Tomáš Ostřížek¹  Beatrix Bencsiková²  Peter Grell²  Eva Lžičařová³  Rudolf Nenutil³  Monika Procházková⁴  Petr Krsička⁵  Roman Šefr⁶  Oldřich Coufal⁶ 

[1] Centre of Cardiovascular and Transplantation Surgery, Pekarska 53, 656 91, Brno, Czech Republic;Department of Comprehensive Cancer Care, Masaryk Memorial Cancer Institute, Zluty kopec, 7, 656 53, Brno, Czech Republic;Department of Oncological and Experimental Pathology, Masaryk Memorial Cancer Institute, Zluty kopec, 7, 656 53, Brno, Czech Republic;Department of Radiology, Masaryk Memorial Cancer Institute, Zluty kopec, 7, 656 53, Brno, Czech Republic;Department of Surgical Oncology, Masaryk Memorial Cancer Institute, Zluty kopec, 7, 656 53, Brno, Czech Republic;Department of Surgical Oncology, Masaryk Memorial Cancer Institute, Zluty kopec, 7, 656 53, Brno, Czech Republic;Department of Surgical Oncology, Faculty of Medicine, Masaryk University, Zluty kopec, 7, 656 53, Brno, Czech Republic;

关键词: Coronary artery bypass;    Mammary arteries;    Necrosis;    Breast;    Carcinoma;   

DOI  :  10.1186/s12957-017-1178-4

 received in 2017-03-16, accepted in 2017-05-23,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundBreast cancer can be diagnosed easily in most cases. However, occasionally, we are faced with some conditions that can mimic it. These may include inflammations, benign tumors, cysts, hematomas, or, more rarely, focal necrosis.Case presentationThis report presents a case of focal breast necrosis following myocardial revascularization with the left internal mammary artery, which is a very rare condition, with only few cases described in the literature. The necrosis becomes usually apparent a few days or weeks after the surgery and is often coincidental with the dehiscence of sternotomy with necrosis of wound edges. As it mostly affects the skin, it can be easily recognized. Also, our patient developed a dehisced sternotomy shortly after the surgery but there were no obvious objective changes on the breast. The condition was first dominated only by non-specific subjective symptom—pain. Later, a lump in the breast occurred, when the sternotomy had already healed. Moreover, an enlarged lymph node was palpable in the axilla. Because of non-typical symptoms, the condition was suggestive of breast cancer for a relatively long time. The patient had suffered from a very strong pain until she was treated by mastectomy with a good clinical result.ConclusionsMammary necrosis following the coronary artery bypass is rare. In most cases, it manifests on the skin shortly after the surgery concurrently with dehisced sternotomy, so it can be easily diagnosed. However, in sporadic cases, the symptoms may occur later and may mimic breast cancer. Our objective is to raise awareness of this rare condition.

【 授权许可】

CC BY   
© The Author(s). 2017