Imaging of a Mucocele-Like Lesion of the Breast: A Case Report and Literature Review

TL;DR

A rare breast lesion called a mucocele-like lesion was diagnosed in a 61-year-old woman, showing how it can look like cancer on imaging and why surgery is needed for a clear diagnosis.

Contribution

This case report adds to the understanding of the imaging features and diagnostic challenges of mucocele-like lesions in the breast.

Findings

Mammography showed a 10 mm asymmetry without microcalcifications, but ultrasound did not confirm the finding.

Biopsy revealed benign mucin, but surgery was needed to confirm the diagnosis and rule out cancer.

The case highlights the variability in imaging appearance and the need for excision for accurate diagnosis.

Abstract

Mucocele-like lesions (MLLs) of the breast are rare mucin-producing lesions that can closely mimic malignant mucinous neoplasms on imaging and histopathology. We present the case of a 61-year-old woman with a non-palpable MLL of the left breast detected on screening mammography. Mammography demonstrated a 10 mm asymmetry visible on a single mediolateral oblique view in the upper outer quadrant of the left breast, without associated microcalcifications. Targeted ultrasonography did not demonstrate a definitive correlate corresponding to the mammographic finding. Stereotactic core needle biopsy revealed abundant extracellular mucin without malignant cells, raising a differential diagnosis that included a benign MLL versus invasive mucinous carcinoma. Surgical excision confirmed a benign MLL with acellular mucin and focal atypical ductal hyperplasia in adjacent tissue. This case highlights the imaging variability of MLLs and underscores the importance of surgical excision for definitive diagnosis and exclusion of concurrent malignancy.

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