Unusual presentation of a benign breast mass: Extensive skin necrosis in the setting of tumour: A Diagnostic dilemma.

Kusum Meena; Sujata Singla; Brijesh Singh

Volume : VIII, Issue : IX, September - 2018

Unusual presentation of a benign breast mass: Extensive skin necrosis in the setting of tumour: A Diagnostic dilemma.

Kusum Meena, Sujata Singla, Brijesh Singh

Abstract :

Background

Phylloids tumours of the east are fioepithelial neoplasm and they are notorious for local recurrence in about 19% of patients. The presence of a east lump is the cause of great anxiety in the patient and source of a great concern to a surgeon because, a significant number can turn out malignant onevaluation. The usual management protocol is based on the assumption that mass is cancerous until proven otherwise. Isolated necrotizing fasciitis or skin necrosis of east is rare in surgical practicemore so in absence of anyco–morbidity.Very large tumours can have skin necrosis at pressure points.

Case report

We are reporting a case of a 40years lady presented with a rapidly increasing mass, occupying almost whole of herrighteast and extensive ulceration over the east mimicking inflammatory carcinoma of east which has very grave prognosis.

Conclusion

The emphasis on reporting this case is to discuss the management of benign east lump in setting of not so familiar clinical presentation and reporting two relatively lesser known entities necrotizing fasciitis and phylloid tumour altogether.The Indian society is deeply rooted in myths and illogical beliefs to such an extent especially for treatment of east lump that it becomes the major cause behind late presentation of benign as well as malignant east lump. So it is the attending surgeon’s responsibility to make prompt diagnosis and offer optimal treatment. Comprehensive clinical history ,thorough clinical examination ,thoughtful use of radiological and pathological tools ,knowledge of gross picture of phylloids tumours and wide local excision of these tumours without leaving doubtful tissue in the vicinity of east and meticulous follow–up regimen are key to achieve success in cure from phylloids tumours of east.