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Evaluation of Surgical Treatment and Intraoperative Local Steroid Application Outcomes in Granulomatous Mastitis

Yıl 2024, Cilt: 46 Sayı: 6, 906 - 911, 07.11.2024
https://doi.org/10.20515/otd.1498140

Öz

Granulomatous mastitis is a rare benign inflammatory disease of the breast. Although the etiology of granulomatous mastitis is not known exactly, it can be confused with breast cancer due to its findings and appearance. In addition, this disease, which is characterised by inflammation, causes recurrent infections and considerable tissue loss if left untreated. Therefore, diagnosis and early treatment are very important. In our study, we aimed to show the results of intraoperative local steroid administration after surgical resection in the treatment of patients with granulomatous mastitis. In our study, the hospital records and files of 39 patients diagnosed with granulomatous mastitis and treated with surgical treatment and intraoperative local steroid administration were retrospectively analysed. Age, gender, radiological and laboratory findings, surgical methods, postoperative recurrence rates and histopathological features were noted. Success rates were investigated and it was observed that intrathecal steroid treatment given after resection decreased recurrence. As a result, it was concluded that surgical wide or total excision and intraoperative local steroid administration would be the most appropriate treatment for the definitive treatment of granulomatous mastitis. Although abscess drainage and antibiotic treatment is effective in rare cases, surgical treatment should be preferred in chronic and complicated cases.

Etik Beyan

Ethics committee approval was obtained by Eskişehir Osmangazi University Non-Interventional Ethics Committee with decision number 2023-245.

Kaynakça

  • 1. Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol. 1972;58:642–6.
  • 2. Diesing D, Axt-Fliedner R, Hornung D, Weiss JM, Diedrich K, Friedrich M. Granulomatous mastitis. Arch Gynecol Obstet. 2004;269:233–6.
  • 3. Tse GM, Poon CS, Ramachandram K, et al. Granulomatous mastitis: A clinicopathological review of 26 cases. Pathology. 2004;36:254–7.
  • 4. Panzacchi R, Gallo C, Fois F, et al. Primary sarcoidosis of the breast: case description and review of the literature. Pathologica. 2010;102:104–7.
  • 5. Bani-Hani KE, Yaghan RJ, Matalka II, Shatnawi NJ. Idiopathic granulomatous mastitis: Time to avoid unnecessary mastectomies. Breast J. 2004;10:318–22.
  • 6. Heer R, Shrimankar J, Griffith CDM. Granulomatous mastitis can mimic breast cancer on clinical, radiological or cytological examination: a cautionary tale. Breast. 2003;12:283–6.
  • 7. Çakır B, Tunçbilek N, Karakaş HM, Ünlü E, Özyılmaz F. Granulomatous mastitis mimicing breast carcinoma. Breast J. 2002;8:251–2.
  • 8. Imoto S, Kitaya T, Kodama T, et al. Idiopathic granulomatous mastitis: case report and review of the literature. Jpn J Clin Oncol 1997; 27: 274-247. doi.org/10.1093/jjco/27.4.274
  • 9. Hur SM, Cho DH, Lee SK, et al. Experience of treatment of patients with granulomatous lobular mastitis. J Korean Surg Soc. 2013;85:1–6.
  • 10. Pistolese CA, Di Trapano R, Girardi V, Costanzo E, Di Poce I, Simonetti G. An unusual case of bilateral granulomatous mastitis. Case Rep Radiol. 2013;2013 694697.
  • 11. Kim J, Tymms KE, Buckhingham JM. Methotrexate in the management of granulomatous mastitis. ANZ J Surg. 2003;73:247–9.
  • 12. Pandhi D, Verna P, Sharma S, Dhawan AK. Borderline-lepromatous leprosy manifesting as granulomatous mastitis. Lepr Rev. 2012;83:202–4.
  • 13. Ditmyer H, Craig L. Mycotic mastitis in three dogs due to Blastomyces bermatitidis. J Am Anim Hosp Assoc. 2011;47:356–8.
  • 14. Akçay MN, Sağlam L, Polat P, Erdoğan F, Albayrak Y, Povoski SP. Mammary tuberculosis-importance of recognition and differentiation from that of a breast malignancy: report of three cases and review of the literature. World J Surg Oncol. 2007;5:67.
  • 15. Al-Khaffaf B, Knox F, Bundred NJ. Idiopathic granulomatous mastitis: A 25 year experience. J Am Coll Surg. 2008;206:267–73.
  • 16. Ocal K, Dag A, Turkmenoglu O, et al. Granulomatous mastitis: clinical, pathological features, and management. Breast J 2010; 16: 176-182.
  • 17. Han BK, Choe YH, Park JM. Granulomatous mastitis: mamographic and sonographic apperances. Am J Radiol 1999; 57: 1001-1006.
  • 18. Baslaim MM, Khayat HA, Al-Amoudi SA. Idiopathic granulomatous mastitis: a heterogeneous disease with variable clinical presentation. World J Surg. 2007; 31: 1677-1681. doi.org/10.1007/s00268-007-9116-1
  • 19. Erhan Y, Veral A, Kara E, et al. A clinicopthologic study of a rare entity mimicking breast carcinoma: idiopathic granulomatous mastitis. Breast 2000; 9: 52-56. doi.org/10.1054/brst.1999.0072
  • 20. Hee RNS, Kuk YN, Hyun EY, et al. Differential diagnosis in idiopathic granulomatous mastitis and tuberculous mastitis. J Breast Cancer. 2012;15:111–8.
  • 21. Peyvandi LB, Klpfel N, Grant E, Lyengar G. Granulomatous lobular mastitis: Imaging, diagnosis, and treatment. AJR. 2009;193:574–81.
  • 22. Kok KY, Telisinghe PU. Granulomatous mastitis: Presentation, treatment and outcome in 43 patients. Surgeon. 2010;8:197–201.
  • 23. Erözgen F, Ersoy YE, Akaydın M, et al. Corticosteroid treatment and timing of surgery in idiopathic granulomatous mastitis confusing with breast carcinoma. Breast Cancer Research and Treatment. 2010;123:447–52.
  • 24. Akyıldız EÜ, Aydoğan F, İlvan Ş, Calay Z. İdiopathic granulomatous mastitis. J Breast Health. 2010;6:5–8.
  • 25. Aksoy Ş, Aren A, Karagöz B, et al. Granülomatöz mastit ve cerrahi tedavi. İstanbul Tıp Dergisi. 2010;11:164–7.
  • 26. Gürleyik G, Aktekin A, Aker F, Karagülle H, Sağlam A. Surgical treatment of idiopathic granulomatous lobulşar mastitis. J Breast Cancer. 2012;15:119–23.
  • 27. Bellavia M, Damiano G, Palumbo VD, et al. Granulomatous mastitis during chronic antidepressant therapy: Is it possible a conservative therapeutic approach? J Breast Cancer. 2012;15:371–2.
  • 28. Lin CH, Hsu CW, Tsoo T, Chou J. Idiopatic granulomatous mastitis associated with risperidone-induced hyperprolactinemia. Diagn Pathol. 2012;7:2.
  • 29. Csemi G, Szajiki K. Granulomatous lobular mastitis following drug-induced galactorrhea and blunt trauma. Breast J. 1999;5:398–400.
  • 30. Garcia-Rodiguez JA, Pattullo A. Idiopathic granulomatous mastitis: a mimicking disease in a pregnant woman: a case report. BMC Research Notes. 2013;6:95.
  • 31. Tuli R, O’hara BJ, Hines J, Rosenberg AL. Idiopathic granulomatous mastitis masquerading as carcinoma of the breast: a case report and review of the literature. Int Semin Surg Oncol. 2007;4:21.
  • 32. Al-Jarrah A, Taranikanti V, Lakhtakia R, Al-Jahri A, Sawhney S. Idiopathic granulomatous mastitis. Diagnostic strategy and therapeutic implications in Omani patients. Sultan Qaboos Univ Med J. 2013;13:241–7.
  • 33. Asoğlu O, Özmen V, Karanlık H, et al. Feasibility of surgical management in patients with granulomatous mastitis. Breast J. 2005;11:108–14.
  • 34. Cuervo SI, Bonilla DA, Murcia MI, et al. Tuberculosis of the breast. Biomedica. 2013;33:36–41.
  • 35. Eroğlu A, Kürkçüoğlu C, Karaoğlanoğlu N, Kaynar H. Breast mass caused by rib tuberculosis abscess. Eur J Cardiothorac Surg. 2002;22:324–6.
  • 36. Rajagopala S, Agarwal R. Tuberculous mastitis in men: case report and systematic review. Am J Med. 2008;121:539–44.
  • 37. Khanna R, Prasanna GV, Gupta P, Kumar M, Khanna S, Khanna AK. Mammary tuberculosis: report on 52 cases. Postgraduate Med J. 2002;78:422–4.

Granülomatöz Mastitte Cerrahi Tedavi ve İntraoperatif Lokal Steroid Uygulamasının Sonuçlarının Değerlendirilmesi

Yıl 2024, Cilt: 46 Sayı: 6, 906 - 911, 07.11.2024
https://doi.org/10.20515/otd.1498140

Öz

Granülomatöz mastit, memenin nadir görülen benign inflamatuar hastalıklarından biridir. Granülomatöz mastit etyolojisi tam olarak bilinmese de bulgular ve görünüm nedeniyle meme kanseri ile karışabilmektedir. Bunun yanında inflamasyonla seyreden bu hastalık tedavi edilmez ise tekrarlayan enfeksiyonlara ve oldukça büyük doku kaybına neden olmaktadır. Bu nedenle tanı konulması ve erken tedavi edilmesi oldukça önemlidir. Biz de çalışmamızda granülomatöz mastitli hastaların tedavisinde cerrahi rezeksiyon sonrası intraoperatif lokal steroid uygulamasının sonuçlarını göstermeyi amaçladık. Çalışmamızda granülomatöz mastit tanısı almış ve cerrahi tedavi ile intraoperatif lokal steroid uygulanmış 39 olgunun hastane kayıtları ve dosyaları retrospektif olarak incelendi. Olguların yaş, cinsiyet, radyolojik ve laboratuvar bulguları, cerrahi yöntemleri, cerrahi sonrası nüks oranları ve histopatolojik özellikleri not edildi. Başarı oranları araştırıldı ve rezeksiyon sonrasında verilen intratekal steroid tedavisinin nüksü azalttığı gözlendi. Bunun sonucunda granülomatöz mastitlerin kesin tedavisi için cerrahi olarak geniş veya total eksizyon ile intraoperatif lokal steroid uygulaması en uygun tedavi olacağı kanaatine varılmıştır. Nadir olgularda apse drenajı ile antibiyotik tedavisi etkin olmakla beraber, kronikleşen ve komplike olmuş vakalarda cerrahi tedavi tercih edilmelidir.

Kaynakça

  • 1. Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol. 1972;58:642–6.
  • 2. Diesing D, Axt-Fliedner R, Hornung D, Weiss JM, Diedrich K, Friedrich M. Granulomatous mastitis. Arch Gynecol Obstet. 2004;269:233–6.
  • 3. Tse GM, Poon CS, Ramachandram K, et al. Granulomatous mastitis: A clinicopathological review of 26 cases. Pathology. 2004;36:254–7.
  • 4. Panzacchi R, Gallo C, Fois F, et al. Primary sarcoidosis of the breast: case description and review of the literature. Pathologica. 2010;102:104–7.
  • 5. Bani-Hani KE, Yaghan RJ, Matalka II, Shatnawi NJ. Idiopathic granulomatous mastitis: Time to avoid unnecessary mastectomies. Breast J. 2004;10:318–22.
  • 6. Heer R, Shrimankar J, Griffith CDM. Granulomatous mastitis can mimic breast cancer on clinical, radiological or cytological examination: a cautionary tale. Breast. 2003;12:283–6.
  • 7. Çakır B, Tunçbilek N, Karakaş HM, Ünlü E, Özyılmaz F. Granulomatous mastitis mimicing breast carcinoma. Breast J. 2002;8:251–2.
  • 8. Imoto S, Kitaya T, Kodama T, et al. Idiopathic granulomatous mastitis: case report and review of the literature. Jpn J Clin Oncol 1997; 27: 274-247. doi.org/10.1093/jjco/27.4.274
  • 9. Hur SM, Cho DH, Lee SK, et al. Experience of treatment of patients with granulomatous lobular mastitis. J Korean Surg Soc. 2013;85:1–6.
  • 10. Pistolese CA, Di Trapano R, Girardi V, Costanzo E, Di Poce I, Simonetti G. An unusual case of bilateral granulomatous mastitis. Case Rep Radiol. 2013;2013 694697.
  • 11. Kim J, Tymms KE, Buckhingham JM. Methotrexate in the management of granulomatous mastitis. ANZ J Surg. 2003;73:247–9.
  • 12. Pandhi D, Verna P, Sharma S, Dhawan AK. Borderline-lepromatous leprosy manifesting as granulomatous mastitis. Lepr Rev. 2012;83:202–4.
  • 13. Ditmyer H, Craig L. Mycotic mastitis in three dogs due to Blastomyces bermatitidis. J Am Anim Hosp Assoc. 2011;47:356–8.
  • 14. Akçay MN, Sağlam L, Polat P, Erdoğan F, Albayrak Y, Povoski SP. Mammary tuberculosis-importance of recognition and differentiation from that of a breast malignancy: report of three cases and review of the literature. World J Surg Oncol. 2007;5:67.
  • 15. Al-Khaffaf B, Knox F, Bundred NJ. Idiopathic granulomatous mastitis: A 25 year experience. J Am Coll Surg. 2008;206:267–73.
  • 16. Ocal K, Dag A, Turkmenoglu O, et al. Granulomatous mastitis: clinical, pathological features, and management. Breast J 2010; 16: 176-182.
  • 17. Han BK, Choe YH, Park JM. Granulomatous mastitis: mamographic and sonographic apperances. Am J Radiol 1999; 57: 1001-1006.
  • 18. Baslaim MM, Khayat HA, Al-Amoudi SA. Idiopathic granulomatous mastitis: a heterogeneous disease with variable clinical presentation. World J Surg. 2007; 31: 1677-1681. doi.org/10.1007/s00268-007-9116-1
  • 19. Erhan Y, Veral A, Kara E, et al. A clinicopthologic study of a rare entity mimicking breast carcinoma: idiopathic granulomatous mastitis. Breast 2000; 9: 52-56. doi.org/10.1054/brst.1999.0072
  • 20. Hee RNS, Kuk YN, Hyun EY, et al. Differential diagnosis in idiopathic granulomatous mastitis and tuberculous mastitis. J Breast Cancer. 2012;15:111–8.
  • 21. Peyvandi LB, Klpfel N, Grant E, Lyengar G. Granulomatous lobular mastitis: Imaging, diagnosis, and treatment. AJR. 2009;193:574–81.
  • 22. Kok KY, Telisinghe PU. Granulomatous mastitis: Presentation, treatment and outcome in 43 patients. Surgeon. 2010;8:197–201.
  • 23. Erözgen F, Ersoy YE, Akaydın M, et al. Corticosteroid treatment and timing of surgery in idiopathic granulomatous mastitis confusing with breast carcinoma. Breast Cancer Research and Treatment. 2010;123:447–52.
  • 24. Akyıldız EÜ, Aydoğan F, İlvan Ş, Calay Z. İdiopathic granulomatous mastitis. J Breast Health. 2010;6:5–8.
  • 25. Aksoy Ş, Aren A, Karagöz B, et al. Granülomatöz mastit ve cerrahi tedavi. İstanbul Tıp Dergisi. 2010;11:164–7.
  • 26. Gürleyik G, Aktekin A, Aker F, Karagülle H, Sağlam A. Surgical treatment of idiopathic granulomatous lobulşar mastitis. J Breast Cancer. 2012;15:119–23.
  • 27. Bellavia M, Damiano G, Palumbo VD, et al. Granulomatous mastitis during chronic antidepressant therapy: Is it possible a conservative therapeutic approach? J Breast Cancer. 2012;15:371–2.
  • 28. Lin CH, Hsu CW, Tsoo T, Chou J. Idiopatic granulomatous mastitis associated with risperidone-induced hyperprolactinemia. Diagn Pathol. 2012;7:2.
  • 29. Csemi G, Szajiki K. Granulomatous lobular mastitis following drug-induced galactorrhea and blunt trauma. Breast J. 1999;5:398–400.
  • 30. Garcia-Rodiguez JA, Pattullo A. Idiopathic granulomatous mastitis: a mimicking disease in a pregnant woman: a case report. BMC Research Notes. 2013;6:95.
  • 31. Tuli R, O’hara BJ, Hines J, Rosenberg AL. Idiopathic granulomatous mastitis masquerading as carcinoma of the breast: a case report and review of the literature. Int Semin Surg Oncol. 2007;4:21.
  • 32. Al-Jarrah A, Taranikanti V, Lakhtakia R, Al-Jahri A, Sawhney S. Idiopathic granulomatous mastitis. Diagnostic strategy and therapeutic implications in Omani patients. Sultan Qaboos Univ Med J. 2013;13:241–7.
  • 33. Asoğlu O, Özmen V, Karanlık H, et al. Feasibility of surgical management in patients with granulomatous mastitis. Breast J. 2005;11:108–14.
  • 34. Cuervo SI, Bonilla DA, Murcia MI, et al. Tuberculosis of the breast. Biomedica. 2013;33:36–41.
  • 35. Eroğlu A, Kürkçüoğlu C, Karaoğlanoğlu N, Kaynar H. Breast mass caused by rib tuberculosis abscess. Eur J Cardiothorac Surg. 2002;22:324–6.
  • 36. Rajagopala S, Agarwal R. Tuberculous mastitis in men: case report and systematic review. Am J Med. 2008;121:539–44.
  • 37. Khanna R, Prasanna GV, Gupta P, Kumar M, Khanna S, Khanna AK. Mammary tuberculosis: report on 52 cases. Postgraduate Med J. 2002;78:422–4.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Genel Cerrahi
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Bartu Badak 0000-0003-3465-8719

Ahmet Murat Sendil 0000-0001-6307-5390

Arda Şakir Yılmaz 0000-0003-1269-0814

Mustafa Salış 0000-0002-3085-0087

Yayımlanma Tarihi 7 Kasım 2024
Gönderilme Tarihi 8 Haziran 2024
Kabul Tarihi 27 Eylül 2024
Yayımlandığı Sayı Yıl 2024 Cilt: 46 Sayı: 6

Kaynak Göster

Vancouver Badak B, Sendil AM, Yılmaz AŞ, Salış M. Evaluation of Surgical Treatment and Intraoperative Local Steroid Application Outcomes in Granulomatous Mastitis. Osmangazi Tıp Dergisi. 2024;46(6):906-11.


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