Diabetic mastopathy: a case report
Summary: Diabetic mastopathy (MD) was described for the first time in 1984 by Soler and Khardori, in insulin-dependent patients with type I diabetes, representing 1% of benign mastopathy. The clinical-imaging presentation raises carcinomas or benign lesions such as fibroadenomas as the main differen...
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| Formato: | Artículo revista |
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Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología
2021
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| Acceso en línea: | https://revistas.unc.edu.ar/index.php/med/article/view/34899 |
| Aporte de: |
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I10-R327-article-34899 |
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Universidad Nacional de Córdoba |
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I-10 |
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R-327 |
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Revista de la Facultad de Ciencias Médicas de Córdoba |
| format |
Artículo revista |
| topic |
Diabetes mastopathy differential diagnosis cáncer Diabetes mastopatía diagnóstico diferencial cáncer . |
| spellingShingle |
Diabetes mastopathy differential diagnosis cáncer Diabetes mastopatía diagnóstico diferencial cáncer . Ceballos , R Fonseca , I Guerini , J Asis , G Diabetic mastopathy: a case report |
| topic_facet |
Diabetes mastopathy differential diagnosis cáncer Diabetes mastopatía diagnóstico diferencial cáncer . |
| author |
Ceballos , R Fonseca , I Guerini , J Asis , G |
| author_facet |
Ceballos , R Fonseca , I Guerini , J Asis , G |
| author_sort |
Ceballos , R |
| title |
Diabetic mastopathy: a case report |
| title_short |
Diabetic mastopathy: a case report |
| title_full |
Diabetic mastopathy: a case report |
| title_fullStr |
Diabetic mastopathy: a case report |
| title_full_unstemmed |
Diabetic mastopathy: a case report |
| title_sort |
diabetic mastopathy: a case report |
| description |
Summary:
Diabetic mastopathy (MD) was described for the first time in 1984 by Soler and Khardori, in insulin-dependent patients with type I diabetes, representing 1% of benign mastopathy.
The clinical-imaging presentation raises carcinomas or benign lesions such as fibroadenomas as the main differential diagnoses, for which excisional biopsy is the treatment of choice.
The communication of this case aims to highlight the importance of the differential diagnosis of this low incidence breast disease entity whose etiology is systemic.
This is a 45-year-old patient, native from Córdoba capital, taxi driver, with a toxic history of smoking and alcoholism; Personal pathological history of type I diabetes treated with NPH insulin and good glycemic controls.
She consulted due to the presentation of a right breast phlogotic erythematous tumor of 40 days of evolution. She had undergone antibiotic treatment for two weeks, without obtaining a response.
A mammogram was performed in the right breast, finding a radiopaque area with diffuse lobulated edges that caused retraction of the nipple and frank skin thickening, with a proliferative appearance (BIRADS classification V).
An incisional biopsy and drainage are performed, indicating hospitalization and combined antibiotic treatment (clindamycin + gentamicin).
It evolves favorably and subsequently a pathological anatomy report is received. In the macroscopy, four irregularly shaped tissue fragments of approximately 2x1 cm are observed, which present a whitish color and firm consistency in the cut.
Histopathology reports slices processed with standard techniques and stained with H-E exhibiting in the breast tissue dense stroma, prominent hyaline bundles of collagen, blood vessels with thickened hyaline walls, which produce lumen stenosis. There is an important mononuclear inflammatory infiltrate, neutrophil polymorphonuclear leukocytes and histiocytes, ducts with epithelial cells reactive to the inflammatory process, and areas of necrosis and skin with polymorphonuclear leukocytes in transepithelial migration. This findings described are linked to diabetic mastopathy / acute nonspecific mastitis.
The clinical case, highlights the fact that when we are faced with a clinical-imaging lesion suggestive of malignancy, it is essential to always consider the clinical context, because despite its low prevalence, DM is an entity to consider, especially in patients with a history of type diabetes I. |
| publisher |
Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología |
| publishDate |
2021 |
| url |
https://revistas.unc.edu.ar/index.php/med/article/view/34899 |
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AT ceballosr diabeticmastopathyacasereport AT fonsecai diabeticmastopathyacasereport AT guerinij diabeticmastopathyacasereport AT asisg diabeticmastopathyacasereport AT ceballosr mastopatiadiabeticareportedeuncaso AT fonsecai mastopatiadiabeticareportedeuncaso AT guerinij mastopatiadiabeticareportedeuncaso AT asisg mastopatiadiabeticareportedeuncaso AT ceballosr a AT fonsecai a AT guerinij a AT asisg a |
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2024-09-03T21:02:44Z |
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2024-09-03T21:02:44Z |
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| spelling |
I10-R327-article-348992024-04-15T16:19:09Z Diabetic mastopathy: a case report Mastopatía Diabética: reporte de un caso A Ceballos , R Fonseca , I Guerini , J Asis , G Diabetes mastopathy differential diagnosis cáncer Diabetes mastopatía diagnóstico diferencial cáncer . Summary: Diabetic mastopathy (MD) was described for the first time in 1984 by Soler and Khardori, in insulin-dependent patients with type I diabetes, representing 1% of benign mastopathy. The clinical-imaging presentation raises carcinomas or benign lesions such as fibroadenomas as the main differential diagnoses, for which excisional biopsy is the treatment of choice. The communication of this case aims to highlight the importance of the differential diagnosis of this low incidence breast disease entity whose etiology is systemic. This is a 45-year-old patient, native from Córdoba capital, taxi driver, with a toxic history of smoking and alcoholism; Personal pathological history of type I diabetes treated with NPH insulin and good glycemic controls. She consulted due to the presentation of a right breast phlogotic erythematous tumor of 40 days of evolution. She had undergone antibiotic treatment for two weeks, without obtaining a response. A mammogram was performed in the right breast, finding a radiopaque area with diffuse lobulated edges that caused retraction of the nipple and frank skin thickening, with a proliferative appearance (BIRADS classification V). An incisional biopsy and drainage are performed, indicating hospitalization and combined antibiotic treatment (clindamycin + gentamicin). It evolves favorably and subsequently a pathological anatomy report is received. In the macroscopy, four irregularly shaped tissue fragments of approximately 2x1 cm are observed, which present a whitish color and firm consistency in the cut. Histopathology reports slices processed with standard techniques and stained with H-E exhibiting in the breast tissue dense stroma, prominent hyaline bundles of collagen, blood vessels with thickened hyaline walls, which produce lumen stenosis. There is an important mononuclear inflammatory infiltrate, neutrophil polymorphonuclear leukocytes and histiocytes, ducts with epithelial cells reactive to the inflammatory process, and areas of necrosis and skin with polymorphonuclear leukocytes in transepithelial migration. This findings described are linked to diabetic mastopathy / acute nonspecific mastitis. The clinical case, highlights the fact that when we are faced with a clinical-imaging lesion suggestive of malignancy, it is essential to always consider the clinical context, because despite its low prevalence, DM is an entity to consider, especially in patients with a history of type diabetes I. Resumen: La mastopatía diabética (MD) fue descripta por primera vez en 1984 por Soler y Khardori, en pacientes insulinodependientes con diabetes tipo I, representando el 1% de la mastopatía benigna. La presentación clínico-imagenológica plantea como principales diagnósticos diferenciales a carcinomas o lesiones benignas tales como los fibroadenomas, por lo cual la biopsia escisional es el tratamiento de elección. La comunicación del presente caso pretende destacar la importancia del diagnóstico diferencial de esta entidad patológica mamaria de baja incidencia cuya etiología es sistémica. Se trata de una paciente de 45 años de edad, oriunda de Córdoba capital, taxista, con antecedentes tóxicos de tabaquismo y etilismo; antecedentes personales patológicos diabetes tipo I tratada con insulina NPH y buenos controles glucémicos. Consulta por guardia central por presentar en mama derecha, tumoración eritematosa flogótica de 40 días de evolución. Había realizado tratamiento antibiótico con amoxicilina-ácido clavulánico durante dos semanas, sin obtener respuesta. Se realiza mamografía encontrándose en mama derecha, área radiopaca de bordes difusos lobulados que provoca retracción del pezón y franco engrosamiento cutáneo, de aspecto proliferativo (clasificación BIRADS V). Se realiza biopsia incisional, drenaje, indicandose internación y tratamiento antibiótico combinado (clindamicina+gentamicina). Evoluciona favorablemente y posteriormente se recibe informe de anatomía patológica. En la macroscopia se observan cuatro fragmentos de tejido de forma irregular de aproximadamente 2x1 cm, los cuales presentan al corte colorido blanquecino y consistencia firme. La histopatología informa cortes procesados con técnicas habituales y coloreados con H&E, que exhiben en el tejido mamario estroma denso, haces hialinos prominentes de colágeno, vasos sanguíneos de paredes hialinas engrosadas, las cuales producen estenosis de la luz. Se observa importante infiltrado inflamatorio mononuclear, leucocitos polimorfonucleares neutrófilos e histiocitos, conductos con células epiteliales reactivas al proceso inflamatorio y áreas de necrosis. Piel con leucocitos polimorfonucleares en migración transepitelial. Los hallazgos descriptos son vinculables a Mastopatía diabética/mastitis aguda inespecífica. El caso clínico expuesto, destaca que ante una lesión clínico-imagenológica sugestiva de malignidad, resulta fundamental considerar siempre el contexto clínico ya que a pesar de su baja prevalencia, la MD es una entidad a considerar, sobre todo en pacientes con antecedentes de diabetes tipo I. . Universidad Nacional Córdoba. Facultad de Ciencias Médicas. Secretaria de Ciencia y Tecnología 2021-10-12 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion texto texto texto https://revistas.unc.edu.ar/index.php/med/article/view/34899 Revista de la Facultad de Ciencias Médicas de Córdoba.; Vol. 78 No. Suplemento (2021): Suplemento JIC XXII Revista de la Facultad de Ciencias Médicas de Córdoba; Vol. 78 Núm. Suplemento (2021): Suplemento JIC XXII Revista da Faculdade de Ciências Médicas de Córdoba; v. 78 n. Suplemento (2021): Suplemento JIC XXII 1853-0605 0014-6722 http://creativecommons.org/licenses/by-nc/4.0 |