A Case of Granulomatous Mastitis Accompanied by Erythema Nodosum

YONEYAMA Kimiyasu, ONODA Noboru

doi:10.3919/jjsa.75.2394

The patient was a 43-year-old woman who visited the clinic with a chief complaint of a painful mass in the left breast. Palpation revealed a mass about 5 cm in diameter on the outer aspect of the left breast with severe tenderness ; no redness of the overlying skin was observed. Therefore, the possibility of purulent mastitis was excluded. Since the symptoms showed no improvement and the mass had increased further in size at follow-up after treatment with antibiotics and an analgesic, the patient was hospitalized for further treatment. A needle biopsy revealed no evidence of malignancy. Since mastitis with significant lymphocytic infiltration was diagnosed, drainage was performed. Three weeks after onset, the patient developed painful erythematous lesions on both lower extremities. A skin biopsy from these lesions revealed perivascular lymphocytic infiltration. Based on the above findings, the patient was diagnosed as having granulomatous mastitis accompanied by erythema nodosum, and she was started on prednisolone treatment. After the start of this treatment, all symptoms, including the erythema and pain, were rapidly alleviated. Since purulent discharge continued from the drainage site on the breast, even after the gradual discontinuation of prednisolone, and with no reduction in the size of the breast mass, the mass was excised. With a good postoperative course and no relapse, the treatment of the patient was completed by 6 months after her first visit.

A Case of Granulomatous Mastitis Accompanied by Erythema Nodosum

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