Traumatic neuroma as a rare cause of intractable neuropathic breast pain following cancer surgery: Management and review of the literature

Abstract

Traumatic neuroma of the breast after cancer surgery is a very rare clinical entity with only a few cases having been reported to date. We herein present a very rare case of traumatic breast neuroma in a postmenopausal patient with a history of breast-conserving surgery, who presented with a four-month history of intractable neuropathic breast pain. Diagnostic evaluation and management are discussed along with a review of the literature. Traumatic breast neuromas are very rare benign lesions that have been reported mainly after mastectomy. Our literature review yielded only 35 cases of traumatic breast neuromas in 28 patients, reported so far. Although imaging features may be indicative of a benign lesion, surgical excision is necessary to obtain a definitive diagnosis and to rule out a recurrent breast cancer. Conservative treatment is feasible in properly selected cases with asymptomatic neuromas after an accurate tissue sampling. The case presented herein underlines the necessity to consider traumatic neuroma in the differential diagnosis in patients with a history of breast surgery presenting with refractory neuropathic breast pain. A high index of suspicion is required because the lesion may be too small and can be missed on imaging investigations.