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A Refractory Case of Granulomatous Mastitis Treated with Methotrexate

Methotrexate로 치료한 불응성 육아종성 유방염 1예

  • Yoo, Jong-Jin (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kang, Eun-Ha (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Lee, Yun-Jong (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Kim, Sung-Won (Department of Surgery, Seoul National University College of Medicine) ;
  • Choi, In-Ah (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Lee, Eun-Bone (Department of Internal Medicine, Seoul National University College of Medicine) ;
  • Song, Yeong-Wook (Department of Internal Medicine, Seoul National University College of Medicine)
  • 유종진 (분당서울대학교병원 내과) ;
  • 강은하 (분당서울대학교병원 내과) ;
  • 이윤종 (분당서울대학교병원 내과) ;
  • 김성원 (서울대학교 의과대학 외과학교실) ;
  • 최인아 (서울대학교 의과대학 내과학교실) ;
  • 이은봉 (서울대학교 의과대학 내과학교실) ;
  • 송영욱 (서울대학교 의과대학 내과학교실)
  • Published : 2012.03.01

Abstract

Granulomatous mastitis (GM) is an uncommon chronic inflammatory disease of the breast that can mimic breast carcinoma or infection. The treatment options include expectant management, complete resection, and corticosteroid therapy, although no standard treatment has been established. Recently, several case reports have suggested that methotrexate is another effective treatment for GM. Here, we describe the first Korean case of recurrent GM successfully treated with low-dose weekly methotrexate and review the relevant literature.

저자들은 육아종성 유방염으로 진단받고 병변의 절제수술과 부신피질호르몬 치료에도 불구하고 반복적으로 재발하고 만성농양과 누공 등의 합병증이 있는 37세 여자 환자에서 MTX를 사용하여 성공적으로 치료한 증례를 경험하였다. 육아종성 유방염에서 재발을 억제하고 부신피질호르몬 사용량을 줄이기 위하여 적극적으로 MTX를 시도할 필요가 있다고 판단하여 문헌고찰과 함께 국내 첫 증례를 보고하는 바이다.

Keywords

References

  1. Kessler E, Wolloch Y. Granulomatous mastitis: a lesion clinically simulating carcinoma. Am J Clin Pathol 1972;58:642-646.
  2. Diesing D, Axt-Fliedner R, Hornung D, Weiss JM, Diedrich K, Friedrich M. Granulomatous mastitis. Arch Gynecol Obstet 2004;269:233-236.
  3. Kim J, Tymms KE, Buckingham JM. Methotrexate in the management of granulomatous mastitis. ANZ J Surg 2003;73: 247-249. https://doi.org/10.1046/j.1445-1433.2002.02564.x
  4. Raj N, Macmillan RD, Ellis IO, Deighton CM. Rheumatologists and breasts: immunosuppressive therapy for granulomatous mastitis. Rheumatology (Oxford) 2004;43:1055-1056.
  5. Katz U, Molad Y, Ablin J, et al. Chronic idiopathic granulomatous mastitis. Ann N Y Acad Sci 2007;1108:603-608. https://doi.org/10.1196/annals.1422.063
  6. Schmajuk G, Genovese MC. First report of idiopathic granulomatous mastitis treated with methotrexate monotherapy. J Rheumatol 2009;36:1559-1560. https://doi.org/10.3899/jrheum.090091
  7. Fletcher A, Magrath IM, Riddell RH, Talbot IC. Granulomatous mastitis: a report of seven cases. J Clin Pathol 1982;35:941-945. https://doi.org/10.1136/jcp.35.9.941
  8. Bruening W, Fontanarosa J, Tipton K, Treadwell JR, Launders J, Schoelles K. Systematic review: comparative effectiveness of core-needle and open surgical biopsy to diagnose breast lesions. Ann Intern Med 2010:152:238-246. https://doi.org/10.7326/0003-4819-152-1-201001050-00190
  9. Erhan Y, Veral A, Kara E, et al. A clinicopthologic study of a rare clinical entity mimicking breast carcinoma: idiopathic granulomatous mastitis. Breast 2000;9:52-56. https://doi.org/10.1054/brst.1999.0072
  10. Olfatbakhsh A, Beheshtian T, Djavid GE. Granulomatous mastitis, erythema nodosum, and oligoarthritis in a pregnant woman. Breast J 2008:14:588-590. https://doi.org/10.1111/j.1524-4741.2008.00653.x
  11. DeHertogh DA, Rossof AH, Harris AA, Economou SG. Prednisone management of granulomatous mastitis. N Engl J Med 1980;303:799-800. https://doi.org/10.1056/NEJM198010023031406
  12. Ayeva-Derman M, Perrotin F, Lefrancq T, Roy F, Lansac J, Body G. Idiopathic granulomatous mastitis: review of the literature illustrated by 4 cases. J Gynecol Obstet Biol Reprod (Paris) 1999;28:800-807.
  13. Tae SY, Lee SW, Han S, et al. Surgical treatment for idiopathic granulomatous mastitis. J Korean Surg Soc 2009;77:153-160. https://doi.org/10.4174/jkss.2009.77.3.153
  14. Lee HK, Yoon CS, Ko SS, et al. Diagnosis and treatment outcome of idiopathic granulomatous mastitis: clinical analysis on 35 cases of granulomatous mastitis. J Korean Surg Soc 2006;71:174-177.
  15. Choi YH, Jung JP, Lee EK, Park YL, Bae WG. Chronic granulomatous mastitis. J Korean Surg Soc 2006;71:90-94.
  16. Lee SD, Park HL, Nam SJ, et al. Diagnosis and treatment of granulomatous mastitis: a study of 12 cases. J Korean Surg Soc 2000;58:487-493.