Unusual Case of Xanthogranulomatous Mastitis with Florid Ductal Epitheliosis, Masquerading Clinically as Neoplastic Breast Lesion

Abstract

Xanthogranulomatous inflammation is a rare form of chronic inflammation characterized by the presence of lipid-laden macrophages, multinucleate giant cells, and chronic inflammatory cells. It is an uncommon finding in the breast. Obstruction, infection with low-virulence organisms, defective lipid transport, autoimmune disorders, and allergic reactions have been implicated. Very few reports of xanthogranulomatous mastitis (XGM) have been reported in which coexistent benign and malignant lesions have been found. Clinical presentation of XGM is variable. Many patients present with pain and breast lumps. The lesions can mimic benign or malignant breast neoplasms clinically and radiologically which warrant a pathological diagnosis either by core or excisional biopsy. Histopathology examination is the key for diagnosis. Surgical excision is the choice of treatment. Larger lesions can be treated conservatively with antibiotics before surgical excision.