Breast tuberculosis: A case report

Abstract

Background: Tuberculosis infects one third of the world population and the leading of death worldwide. Lymphadenitis is the most frequent form of extra pulmonary tuberculosis. Breast tuberculosis is an extremely rare form of extra pulmonary tuberculosis. We introduced a case of breast tuberculosis that presented with axillary sinus tract, left supraclavicular lymph node and left breast edema. Case Report: A 15 year-old girl with a history of left breast swelling and left axillary sinus tract discharge from 2 months ago was admitted to our hospital. The physical examination showed left supraclavicular lymphadenopathy (size=1×0.5, fixed, firm with mild tenderness), left breast mass (size=2×2, firm, mild tenderness) with normal overlying skin, left axillary sinus tract with large mass (size=8×8, tender, erythematous and firm). She has also edema of the chest wall especially in the left hemi thorax. Chest X-Ray was normal and ultrasonographic study of breast showed an ovaloid mass (13×29) with cystic structure and multiple septations. Abdominopelvic sonography was normal and PPD was negative. Excisional biopsy of left axillary lesion showed granuloma and caseous necrosis compatible with tuberculosis. Within 2 weeks of anti-TB medication, the patient developed with left breast discharge. After 6 weeks of anti-TB therapy discharge from this site and left axillary sinus tract was stopped. Conclusion: The tuberculosis of breast is a disease of younger age group and the younger patients usually manifests sign of a pyogenic breast abscess. In our case left breast swelling and left axillary sinus tract discharge were the first presentation of disease. Key words: Breast Tuberculosis, Edema, Axillary sinus tract.