Plasma Cell Mastitis mimicking as carcinoma of the breast: A case report and review of the literature

Abstract

Plasma Cell Mastitis (PCM) is an uncommon chronic inflammatory disease of the breast in middle aged women. Patient presents with symptoms of acute mastitis with an abscess or abscesses. Later persists as diffuse lump with nipple discharge. Discharge can be milky, purulent or bloody with axillary lymphadenopathy. Clinically it is very difficult to differentiate from carcinoma (Ca) breast. Microcalcification on mammography makes further confusion in differentiating from carcinoma. The treatment is wide excision and recurrence is common as it is a diffuse inflammatory mass. Total mastectomy is needed when lump is large, to ovoid local recurrence. Total mastectomy for a benign lesion is not acceptable as there is psychological trauma to patient. Two cases were reported in the literature with shock and toxemia postoperatively. Two cases presented as comedo type of adenocarcinoma. We had a similar case of breast lump where there was difficulty in diagnosing the case. The clinical course in our case was similar to cases described in the literature. Therefore we are presenting this case with review of literature keeping rarity of the disease, difficulties in the diagnosis and treatment.