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Pilonidal abscess of the breast
Joseph Keighley1,2, Aishah Nadim2, David Howlett3
1Radiology Department, Brighton and Sussex University Hospitals NHS Trust, Brighton, UK.
Insights
Pilonidal abscess, typically in the natal cleft, can rarely occur in the breast. This case highlights its importance as a differential diagnosis for breast abscesses, especially recurrent or slow-resolving ones.
Area of Science:
- General Surgery
- Dermatology
- Pathology
Background:
- Pilonidal disease commonly affects the natal cleft in adult males.
- Pilonidal sinus at extragluteal sites is infrequently documented.
- Breast abscesses are common presentations in women's breast clinics.
Observation:
- A 52-year-old woman presented with nipple inversion and breast pain.
- Clinical and imaging findings indicated a periareolar breast abscess.
- The abscess recurred despite initial antibiotic treatment and needle aspiration.
Findings:
- Surgical excision and subsequent histology confirmed a pilonidal abscess in the breast.
- This represents a rare presentation of pilonidal disease.
- Pilonidal abscess is a crucial differential diagnosis for breast abscesses.
Implications:
- Consider pilonidal abscess in the differential diagnosis of breast abscesses, particularly those with atypical presentations.
- Recurrent or slow-resolving breast abscesses warrant thorough investigation for less common etiologies.
- This case expands the known anatomical sites for pilonidal disease and its clinical recognition.
Abstract:
Pilonidal disease is a common condition, typically occurring in the natal cleft of adult males. Other sites of pilonidal sinus are rarely reported. We report a case of periareolar pilonidal abscess in the breast of a 52-year-old woman who presented via the breast clinic complaining of nipple inversion and pain. Clinical examination and imaging revealed an underlying abscess which recurred despite antibiotic therapy and needle aspiration; the patient therefore underwent surgical excision of the abscess cavity. Subsequent histology diagnosed pilonidal abscess, an important differential to consider in the case of breast abscess, particularly in cases that are slow to resolve or recur post-treatment.
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