Fibrocystic disease within an axillary accessory breast (Kajava class IV): a case report
Rawan Al-Ahmar, Osama Haj Osman, Lina Ghabreau, Kusay AyoubIntroduction:
Accessory breast tissue is a congenital anomaly occurring in 0.4–6% of the population, most commonly in the axilla. While this tissue is subject to the same physiological and pathological changes as orthotopic breast tissue, fibrocystic disease presenting as a large axillary mass is rare, representing a diagnostic challenge that mimics lipomas and other conditions common in the axillary region.
Case presentation:
We report a case of 33-year-old female who presented with a chronic painful mass in the left axilla that have been present for 10 years. Clinical examination revealed a soft, mobile mass without associated nipple or areola (Kajava Class IV). Initially suspected to be a lipoma, ultrasonography suggested ectopic breast tissue. Excisional biopsy was performed, revealing a mass of size 9 × 8.5 x 3.5 cm. Histopathological analysis confirmed benign mammary parenchyma with prominent fibrocystic changes, including ductal ectasia and apocrine metaplasia. The patient showed satisfactory recovery with no recurrence at the 1-month follow-up.
Discussion:
This case emphasizes the importance of including accessory breast tissue in the differential diagnosis of axillary swellings, even when clinical features suggest more common benign lesions like lipomas.
Conclusion:
Early recognition through clinical suspicion, imaging, and histopathological confirmation is crucial, particularly in low-resource settings, to ensure appropriate management and monitor for potential neoplastic transformation.