|Year : 2021 | Volume
| Issue : 2 | Page : 384-385
Accessory mammary gland mimicking sessile lipoma: A rare case report
Suresh Chandak1, Ravi Ponugoti1, Meenakshi Chandak2
1 Department of General Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
2 Department of Dermatology, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences (Deemed to be University), Wardha, Maharashtra, India
|Date of Submission||20-Aug-2020|
|Date of Decision||07-Oct-2020|
|Date of Acceptance||23-Dec-2020|
|Date of Web Publication||18-Oct-2021|
Dr. Suresh Chandak
204, Arihant Apartments, JNMC, Sawangi (Meghe), Wardha - 442 106, Maharashtra
Source of Support: None, Conflict of Interest: None
Accessory mammary gland is an uncommon lesion, which occurs in 0.4%–6% of women. It is mostly located in the axilla of both sides, but when it presents unilateral large in size and sessile, it can cause difficulty in clinical diagnosis, which mimics lipoma or adipose tissue lesion, usually, it is bilateral and presents asymptomatic lump in the axilla during pregnancy and lactational period. Anxiety is the major cause of concern, as the general population are not aware of accessory breast. Histopathological diagnosis is very important as axillary mass or breast tissue may undergo changes like mastitis, fibrocystic disease, and rarely carcinoma. We present an axillary mass on the left side in 24-year-old female, which has been diagnosed with accessory mammary gland on fine-needle aspiration cytology study, which was mimicking sessile lipoma as a rare clinical presentation.
Keywords: Accessory mammary gland, axilla, lipoma
|How to cite this article:|
Chandak S, Ponugoti R, Chandak M. Accessory mammary gland mimicking sessile lipoma: A rare case report. J Datta Meghe Inst Med Sci Univ 2021;16:384-5
| Case Report|| |
A 24-year-old married nonlactating woman presented with a swelling in the left axilla for 2 years, which was painless and became prominent on the abduction of the left upper arm. It was non-tender, not warm, soft, ill-defined margins, 8 cm × 7 cm, mobile and skin was pinchable. Both breasts and right axilla were normal. There was no lymphadenopathy in both axillae. There was no nipple and areola over the mass. Fine-needle aspiration cytology (FNAC) was done, and the report was suggestive of accessory breast. Mass excised and histopathological studies proved the same.
| Discussion|| |
During the 5th or 6th week of embryogenic development, the mammary ridge/milk line develop from anterior axillary folds to the groin, which represses all along the ridge except the pectoral region on both sides, where it forms the normal breast.,,,, Ectopic breast tissue rarely presents as benign lesions like mastopathy, fibroadenoma but carcinoma is rare in ectopic breast tissue.,,
According to Kajava classification 1915, this is class II, which consists of glandular tissue without areola and nipple.,, Aberrant breast tissue is an island of breast tissue, are usually located in close proximity to the breast like axilla., Infraclavicular, Juxtasternal, Epigastric, and Vulvar locations have been described.,,,,,,,,
| Conclusion|| |
Patient had anxiety of axillary mass, which was mimicking lipoma or benign soft-tissue tumor. On FNAC and Histopathological study, it was proved to be accessory breast tissue. Some women have the cosmetic problem too., Hence, it is common presentation on bilateral axilla, but as unilateral mass, there was diagnostic dilemma as a lipoma which has proved as accessory mammary gland. Surgical excision under general anesthesia is the line of treatment to relieve anxiety and cosmetic aspect as well as to prevent long-term complications like carcinoma.,,, Accessory breast is common in the axilla, but it was mimicking soft tissue benign tumor-like lipoma and turned out to be accessory breast on histopathological study after excision [Figure 1].
Declaration of patient consent
The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Haagensen CD. Diseases of the Breast. Philadelphia, PA: W. B. Saunders Co.; 1971.
Greer KE. Accessory axillary breast tissue. Arch Dermatol 1974;109:88-9.
De Cholnoky T. Accessory breast tissue in the axilla. New York J Med 1951;51:2245-8.
Kaye BL. Accessory axillary breast tissue. A significant aesthetic deformity. Plast Reconstr Surg 1974;53:61-3.
Rohrich RJ, Ha RY, Kenkel JM, Adams WP. Classification and management of gynecomastia: Defining the role of ultrasound-assisted liposuction. Plast Reconstr Surg 2003;111:909-23.
Hong JP, Shin HW, Yoo SC, Chang H, Park SH, Koh KS, et al
. Ultrasound-assisted lipoplasty treatment for axillary bromidrosis: Clinical experience of 375 cases. PlastReconstrSurg2004;113:1264-9.
Grossl NA. Supernumerary breast tissue: Historical prospective and clinical features. South Med J 2000;93:29-32.
Shultz M, Vatsayan A. Accessory breast tissue. O and G Magazine 2013;15:64-7.
Loukas M, Clarke P, Tubbs RS. Accessory breasts: A historical and current prospective. Am Surg 2007;73:525-8.
Kajava Y. The proportions of supernumerary nipples in the Finnish population. Duodecim 1915;1:143-70.
Velanovich V. Ectopic breast tissue, supernumerary breasts and supernumerary nipples. South Med J 1995;88:903-6.
Sahu S, Hussain M, Sachan P. Bilateral accessory breast. Internet J Surg 2007;17;1-4.
Lakkawar NJ, Maran G, Srinivasan S, Rangaswamy T. Axillary breast tissue in the axilla in a puerperal woman-case study. Acta Medica Medianae 2010;49:45-7.
Solanki R, Choksi DB, Duttaroy DD. Accessory breast tissue presenting as a large pendulous mass in the axilla: A diagnostic dilemma. N Z Med J 2008;121:76-8.
Jung H, Jung SH. Accessory breast carcinoma. Breast Care 2009;4:104-6.
Bartsich SA, Ofodile FA. Accessory breast tissue in the axilla: Classification and treatment. Plast Reconstr Surg 2011:128:35-6.
Aydogan F, Baqhaki S, Celik V, Kocael A, Gokcal F, Cetinkale O, et al
. Surgical treatment of axillary accessory breasts. Am Surg 2010;76:270-2.
Lesavoy MA, Gomez-Garcia A, Nejdl R, Yospur G, Syiau TJ, Chang P. Axillary breast tissue: Clinical presentation and surgical treatment. Ann Plast Surg 1996;36:661-2.
Down S, Barr L, Baildam AD, Bundred N. Management of accessory breast tissue in axilla. Br J Surg 2003;90:1213-4.
Fan J. Removal of accessory breasts: A novel tumescent liposuction approach. Aesthetic Plast Surg 2009;33:809-13.