A Case of Granulomatous Mastitis with Erythema Nodosum

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 74; no. 7; pp. 1770 - 1773
• Main Authors: KURODA, Toru, YAMADA, Hirofumi, KATSURADA, Junjiro, MATSUMOTO, Rikio
• Format: Journal Article
• Language: Japanese
• Published: Japan Surgical Association 2013
• Subjects: depression; erythema nodosum; granulomatous mastitis
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.74.1770

A 19-year-old woman presented to a neighborhood hospital with a painful and reddening mass of her right breast. As an abscess was observed, incisional drainage was performed. Starting the following day, the patient had a fever of 39°C and thereafter developed erythema nodosum of both lower extremities. As she did not improve the symptoms and walking became difficult due to pain in the lower extremities, she was referred to our hospital and admitted. Although antibiotics and antiphlogistic analgetics were administered, the high fever persisted. As granulomatous mastitis was suspected based on mammary gland needle biopsy results, the patient received oral administration of prednisolone 20 mg/day which led to a rapid temperature reduction and erythematous swelling of the lower extremities diminished markedly. Prednisolone was gradually tapered and finally discontinued at approximately 4 months. The patient has since suffered no relapses. Granulomatous mastitis, a relatively rare disease of unknown cause, is a solitary unilateral breast tumor. Erythema nodosum is painful erythema accompanying subcutaneous induration in extensor surfaces of the bilateral lower extremities ; in some cases the causes are unknown while others are secondary to infection or other diseases. We report this very rare case of granulomatous mastitis with concurrent erythema nodosum, with discussion of the relevant literature.