Isolated panniculitis with vasculitis of the male breast suspicious for malignancy on CT and ultrasound: a case report and literature review.
BACKGROUND
We report a case of a 54-year-old male patient with a hard, painful nodule within his right breast which was misdiagnosed preoperatively as breast cancer.


METHODS
Preoperative work-up included physical examination, non-contrast chest computed tomography (CT), sonography, and sono-guided breast biopsy. Isolated breast panniculitis with vasculitis (BPWV), a rare disease, was diagnosed by histopathologic examination of tissue obtained from excisional biopsy.


RESULTS
Subcutaneous panniculitis with or without vasculitis, a condition of nonsuppurative inflammatory process involving the subcutaneous fat layer of skin, is related to different causes. A palpable benign male breast lesion resembling a malignancy includes gynecomastia, panniculitis with or without vasculitis, fat necrosis, ruptured epidermal cyst, pseudoangiomatous stromal hyperplasia, subareolar abscess, intraductal papilloma, hematoma, and atypical fibroadenoma. To make an accurate preoperative diagnosis of a male breast mass, a physician has to carefully analyze various imaging findings. The cases of BPWV may present as an isolated breast lesion or as a component of a systemic disease. The diagnosis of the reported patient was compatible with an isolated BPWV because panniculitis and/or vasculitis were not present at other sites or organs at the time of diagnosis or during follow-up.


CONCLUSIONS
Excisional biopsy and clinical data can provide the correct diagnosis and determined the appropriate treatment strategy of a male BPWV.
Division of Radiology, Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan ; Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, ShiPai Road, 11217 Taipei City, Beitou District Taiwan ; School of Medicine, National Yang Ming University, Taipei, Taiwan.
Wei-Hsin
WH
Yuan
Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan ; School of Medicine, National Yang Ming University, Taipei, Taiwan.
Anna Fen-Yau
AF
Li
Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, ShiPai Road, 11217 Taipei City, Beitou District Taiwan ; Division of Medical Imaging for Health Management, Cheng Hsin General Hospital, Taipei, Taiwan.
Hui-Chen
HC
Hsu
Department of Radiology, Taipei Veterans General Hospital, No. 201, Sec. 2, ShiPai Road, 11217 Taipei City, Beitou District Taiwan ; School of Medicine, National Yang Ming University, Taipei, Taiwan.
Yi-Hong
YH
Chou
Computed Tomography (CT); Male breast cancer; Panniculitis with vasculitis; Sonography