Displaced epithelium after liposuction for gynecomastia

Area of Science:

• Pathology
• Surgical Oncology
• Endocrinology

Background:

• Gynecomastia, or male breast enlargement, can be treated with liposuction for cosmetic reasons.
• Epithelial cell displacement is a known complication of breast biopsies, including fine-needle aspiration and core needle biopsy.
• The differential diagnosis of breast lesions in men includes invasive ductal carcinoma.

Observation:

• A 36-year-old man with a history of liposuction for gynecomastia underwent an excisional biopsy.
• Histologic examination revealed nests of displaced epithelial cells within the adipose tissue of the breast.
• These findings mimicked the appearance of invasive ductal carcinoma on initial review.

Findings:

• Epithelial cell displacement, typically associated with needle biopsies, was observed in gynecomastia tissue following liposuction.
• This represents a novel presentation of epithelial cell displacement in the context of post-liposuction gynecomastia.
• The histological pattern closely resembled invasive ductal carcinoma, posing a diagnostic challenge.

Implications:

• This case highlights a potential diagnostic pitfall in the histopathological evaluation of male breast tissue after liposuction.
• It underscores the importance of considering iatrogenic causes, such as surgical procedures, when interpreting breast biopsies.
• Further awareness among pathologists and surgeons is crucial to avoid misdiagnosis of invasive ductal carcinoma in similar cases.