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SEBACEOUS CYST IN BREAST: A Rare Presentation

MH SHAIKH*, PK BAVISKAR*, AN MAHSKE**
*Prof. Surgery; **AP Surgery, Department of Surgery, Rural Medical College, Loni, Maharashtra.

Sebaceous cyst can occur anywhere in the body and in all age group. But its occurrence, and huge size in the breast is rare. A unique case of sebaceous cyst of breast is reported.

INTRODUCTION

Sebaceous cyst arises due to the blockage of the sebaceous gland. It occurs anywhere in the body except sole and palm. Its rare occurrence in the postmenopausal female posed clinical dilemma in diagnosis. The chief clinical features, management is presented here.

CASE REPORT

45 year female presented one year after the menopause with the history of lump in the right breast. She noticed a lemon size lump in the right outer middle quadrant of the breast. This increased to the large size during the last six months. It was not associated with the trauma, fever, nipple discharge. Family history and personal history were insignificant. She has three breastfed issues.

Local examination


Huge oval lump with the smooth surface was present in the outer quadrant of the right breast. The skin was fixed at the middle of the lump otherwise it was free. The right nipple was not retracted. The lump was soft, cystic, fluctuant and freely mobile.

Transillumination was negative. It was not fixed to pectoralis major and serratus anterior. Axillary lymph nodes on both sides, both supraclavicular lymph nodes were not palpable. Lt breast was normal.

Thorough preoperative check up was normal. FNAC was nonconclusive.

Provision diagnosis

Cystic lump in the right breast? Benign; ?Early malignancy.

She was posted for the excisional biopsy under general anesthesia. Transverse incision encircling the point where the skin was fixed was taken. The encapsulated lump separated in all the sides and taken out completely. Intraoperative it was diagnosed as sebaceous cyst.

The postoperative period was uneventful.

DISCUSSION

The breast is modified sebaceous gland.[1] Still the sebaceous cyst is rare in the breast.[2] The sebaceous cysts are also called as retention cyst of a gland of Montgomery. These glands are situated near the areola and secrete sebum.[3] The cysts of the breast are : (1) Cystic hyperplasia of fibroadenosis. (2) Chronic abscess. (3) Haematoma. (4) Galactocoele. (5) Hydatid cyst (6) Lymph cyst (7) Serocystic disease of Brodie. (8) Colloid degeneration in carcinoma. (9) Papillary cystadenoma (10) Sebaceous cyst. The sebaceous cyst is formed due to the retention of the sebum due to blockage of its duct. The sebaceous glands are situated in the subareolar region.[4] They occur in any part of the breast. But in the larger examples they lie near the nipple and arise from the tubercle of montgomery.

In our case report she had solitary benign cyst of breast. The cyst was away from the nipple and areola. It attended a huge size in a short period. It is very easy to diagnose the sebaceous cyst. But in our case menopausal age, short history, huge size and skin fixation at one point only pointed to ma lignancy. As it was a mobile swelling we planned to excise the lump and send for HPE. Intraoperatively while separation of the cyst we diagnose as a sebaceous cyst.

CONCLUSION

1.One must keep in mind the possibility of sebaceous cyst in the breast.
2.It had attended the large size without any complication.
3.Whenever there is doubt in the diagnosis it is better to start with the conservative operation than radical one.

ACKNOWLEDGEMENT

We would like to thank our Management and Trustee of Pravara Medical Trust, Loni for permitting us to publish this interesting case.

REFERENCES


1.Alexender Lee Mc Gregor, Plessis DJ. The Breast : A synopsis of Surgical Anatomy : 10th Edition - 34 Chapter VI.

2Baily and Love’s. The Breast : Short Practice of Surgery. 21st Edition : 791.

3.Das S. The Breast : A Manual on Clinical Surgery : 4th Edition. 320.

4.IAN AIRD. The Breast : Manual on Surgery. 616.


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