Multiple cholesterol granulomas of the breast: A case report and review of the literature.

Menglei Jin, Qiang Wu, Bingliang Miao, Jing Jin, Chenyi Gao, Xiaoming Xu, Yingbo Luo, Zhigang Chen

Journal: Medicine 2023;102(8):e33084

PMID: 36827045

Abstract

RATIONALE

Cholesterol granuloma of the breast is a rare disease defined as chronic reactive inflammation of cholesterol crystals and foreign body giant cells. This disease can mimic breast cancer in the clinic as painless palpable hard nodules, and imaging shows irregular hypoechoic nodules with unclear boundaries. Therefore, the uncommon lesions can be easily misdiagnosed as breast cancer. Meanwhile, it can be easily neglected by clinicians because of poor understanding.

PATIENT CONCERNS

In this report, we present a rare case of multiple cholesterol granulomas of the breast, which was analyzed retrospectively and combined with all 11 relevant available studies in the last 50 years.

INTERVENTIONS

The patient had undergone multiple breast imaging inspections for breast nodules and had the local resection of nodules.

DIAGNOSES

The patient was confirmed to have a final diagnosis of benign cholesterol granulomas but was initially considered as breast cancer.

OUTCOMES

The patient did not complain of discomfort after surgery, and ultrasound reexamination 5 months after surgery showed no recurrence.

LESSONS

By retrospective analysis, dynamic contrast-enhanced magnetic resonance imaging and core needle biopsy can synergistically help clinicians distinguish it from other breast disease. To raise awareness of such a rare disease and reduce related misdiagnoses, we summarize the characteristics of cholesterol granulomas and recommend appropriate novel diagnosis and treatment regimens for patients with cholesterol granulomas.

Copyright © 2023 the Author(s). Published by Wolters Kluwer Health, Inc.

Address: Department of Breast Surgery, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.; Department of Surgery, Pangang Xichang Hospital, Xichang, China.; Department of Breast Surgery, Affiliated Hospital of Shaoxing University, Shaoxing, China.; Department of Obstetrics and Gynecology, Shaoxing Maternity and Childcare Hospital, Shaoxing, China.; Department of Pathology, Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
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