Rare Case of Sarcoidosis in Male Breast Tissue Reported

Lindsey Shapiro, PhD avatar

by Lindsey Shapiro, PhD |

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A rare occurrence of sarcoidosis in male breast tissue was observed in an American man, according to a recent case report.

The report, “A Rare Case of Sarcoidosis Involving Male Breast Tissue,” was published in the Cureus Journal of Medical Science.

Sarcoidosis is characterized by the buildup of clumps of inflammatory cells — called granulomas — in tissues throughout the body. While granulomas can be present in several tissues or organs, they are rarely observed in breast tissue, and any such previous reports have been in female patients.

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According to the research team from Tennessee, a 41-year-old African American man arrived at the clinic with complaints of breast tenderness and lumps on both sides that had started five months earlier.

The man had a medical history of sarcoidosis of the lung, in addition to Bell’s palsy — a condition involving facial muscle weakness or paralysis — and Herpes zoster encephalitis, a neurological complication from the varicella-zoster virus. He had no family history of sarcoidosis or breast cancer.

A physical examination revealed breast lumps characterized by the presence of firm nodules.

The clinicians then performed a mammography to examine the man’s breast tissue. Microcalcifications, or small calcium deposits, were observed in some areas of breast tissue. While most calcifications in breast tissue are benign, they can also be a sign of cancer.

“Due to raised clinical concern for the calcifications, a subsequent breast biopsy was performed,” the researchers wrote.

Inflammatory granulomas were observed in the tissue, which were not necrotizing, meaning there was no tissue death. The granulomas contained epithelioid histiocytes, macrophages, and lymphocytes, all of which are types of immune cells.

Fungi and bacteria were not present, nor was evidence of any cancer. Given the clinical features and history of lung sarcoidosis, the masses were determined to be sarcoidosis and were successfully removed.

Sarcoidosis in breast tissue is uncommon, but has been reported in women. Furthermore, sarcoidosis of the breast lymph nodes has been observed in women who also had breast cancer, and women with breast cancer may be at higher risk for sarcoidosis.

In addition to the unlikely occurrence of sarcoidosis in male breast tissue, the condition may also mimic the appearance of cancer when imaging techniques are used, and imaging alone cannot distinguish between cancer and sarcoidosis.

A biopsy is thus necessary to confirm the diagnosis and guide appropriate treatment, the team added.

Although sarcoidosis in male breast tissue now seems rare, “further reporting may reveal more instances of this unique occurrence,” the researchers concluded.