Giant epidermal inclusion cyst with infection arising within the breast parenchyma: a case report

Epidermal inclusion cysts (EICs) of the breast develop in the deep breast parenchyma, and they are very rare. Only about 10 cases have been reported in the English-language literature to date. In this report, we present a rare case of a giant EIC with infection arising within the deep breast parenchyma. Unlike a typical EIC of the breast, the EIC in the present case was a cystic and solid lesion containing a large amount of liquid within the cyst and popcorn-like calcification in the wall. In this report, we describe the contrast-enhanced spectral mammography (CESM), ultrasonography, and computed tomography findings and provide a reference for the diagnosis of EICs. To the best of our knowledge, this is the first report of the CESM findings of an EIC. Our case illustrates that CESM has excellent performance similar to that of magnetic resonance imaging and is much more effective than conventional digital mammography. Additionally, our case indicates that precise correlation of CESM with ultrasonography findings contributes to the diagnosis of EICs. This rare case with multiple imaging findings will increase the awareness of EICs in the breast parenchyma.