PMC9793057_01
Pseudo-tumor right breast, with a retraction of the nipple and an appearance
of "orange peel" resulting from pus to the skin via a skin fistula (blue
circle).
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After 7 days of treatment, a cutaneous fistulization appeared and the inspection of the breast found a clinical sign described as "orange peel," resulting from pus to the skin (Figure 1).
Breast MRI showing lesional ranges as multiple oval and rounded formations
with irregular thick walls in hyposignal T1 (a) and hypersignal T2 (b), with
a peripheral enhancement (c) after fat suppression. Note a homolateral
axillary adenopathy (yellow arrow).
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The MRI found a lesional range made of multiple oval formations, occupying the entire gland and extending to the skin (Figure 2).
Ultrasound aspect of the right breast showing an abscess in the form of a
heterogeneous hypoechoic collection (yellow arrow) with another uncollected
part in heterogeneous echogenic form with posterior enhancement (brown
arrow). Note an axillary adenopathy (blue star).
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The comparison of their fluid signal to the control ultrasound images led to the possibility of an IGM (Figure 3).
(a) Fibrous mammary parenchyma having decentered epithelial-gigantocellular
granulomas of caseous necrosis (yellow arrow), HE x10; (b) fibrous mammary
parenchyma (green arrow) having epithelial-gigantocellular granulomas (red
arrow) not centered with caseous necrosis, HE x 40.
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It showed a fibrous breast parenchyma with a polymorphic inflammatory infiltrate and decentered epithelio-gigantocellular granulomas of caseous necrosis (hematoxylin and eosin (HE) x10) in favor of IGM (Figure 4).