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Granulomatous mastitis with erythema nodosum: A case report and mini‑review of the literature

  • Authors:
    • Ronak Saeed Ahmed
    • Abdulwahid M. Salih
    • Lana R.A. Pshtiwan
    • Aso S. Muhialdeen
    • Karzan M. Salih
    • Masty K. Ahmed
    • Hardi M. Dhahir
    • Shko H. Hussein
    • Halkawt Omer Ali
    • Fahmi H. Kakamad
  • View Affiliations / Copyright

    Affiliations: Department of Scientific Affairs, Smart Health Tower, Sulaymaniyah 46001, Iraq
    Copyright: © Ahmed et al. This is an open access article distributed under the terms of Creative Commons Attribution License [CC BY 4.0].
  • Article Number: 114
    |
    Published online on: September 26, 2025
       https://doi.org/10.3892/wasj.2025.402
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Abstract

Granulomatous mastitis (GM) is a rare chronic inflammatory disease of the breast, often mistaken for malignancy. The present study describes the case of a patient with GM associated with erythema nodosum (EN). A 37‑year‑old female patient presented with a 2‑month history of a painful mass in the left breast, accompanied by bilateral skin lesions on the lower limbs. A physical examination revealed a tender breast mass (3 cm in size) and multiple erythematous subcutaneous nodules on the lower limbs. Laboratory tests revealed an elevated white blood cell count and hypochromic microcytic anemia. A breast ultrasonography demonstrated a hypoechoic mass in the left breast. Core needle biopsy revealed non‑caseating granulomas consistent with GM. The final diagnosis was GM associated with EN. Treatment with prednisolone and colchicine led to the resolution of symptoms within 4 weeks. In addition, a brief literature review identified six studies reporting cases of GM with EN, all of which occurred in female patients aged 16 to 42 years. Of note, three cases had lesions in the right breast. Common presentations included breast pain, swelling and EN with systemic symptoms such as arthralgia. Histopathological analyses consistently showed granulomatous inflammation with negative cultures. Treatment primarily involved the use of corticosteroids, resulting in significant improvement or resolution. In general, an accurate diagnosis of GM is crucial to prevent unnecessary interventions. Management with corticosteroids can lead to favorable outcomes. Understanding systemic associations, such as EN, is vital for comprehensive patient care.
View Figures

Figure 1

Multiple tender subcutaneous nodules
on both legs. (Left panel) Anterior view of the right leg
indicating several erythematous, ill-defined subcutaneous nodules
with overlying erythema. (Right panel) Closer view highlighting
confluent nodules on the anteromedial surface with violaceous
discoloration.

Figure 2

(A) Section of tissue core showing
perilobular mixed inflammatory cell infiltration dark arrow).
Hematoxylin and eosin staining; magnification, x4. (B) Another area
demonstrating well-formed epithelioid granulomas (black arrows)
with multinucleated giant cells (blue arrow). Hematoxylin and eosin
staining; magnification, x10.
View References

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Copy and paste a formatted citation
Spandidos Publications style
Ahmed RS, Salih AM, Pshtiwan LR, Muhialdeen AS, Salih KM, Ahmed MK, Dhahir HM, Hussein SH, Ali HO, Kakamad FH, Kakamad FH, et al: Granulomatous mastitis with erythema nodosum: A case report and mini‑review of the literature. World Acad Sci J 7: 114, 2025.
APA
Ahmed, R.S., Salih, A.M., Pshtiwan, L.R., Muhialdeen, A.S., Salih, K.M., Ahmed, M.K. ... Kakamad, F.H. (2025). Granulomatous mastitis with erythema nodosum: A case report and mini‑review of the literature. World Academy of Sciences Journal, 7, 114. https://doi.org/10.3892/wasj.2025.402
MLA
Ahmed, R. S., Salih, A. M., Pshtiwan, L. R., Muhialdeen, A. S., Salih, K. M., Ahmed, M. K., Dhahir, H. M., Hussein, S. H., Ali, H. O., Kakamad, F. H."Granulomatous mastitis with erythema nodosum: A case report and mini‑review of the literature". World Academy of Sciences Journal 7.6 (2025): 114.
Chicago
Ahmed, R. S., Salih, A. M., Pshtiwan, L. R., Muhialdeen, A. S., Salih, K. M., Ahmed, M. K., Dhahir, H. M., Hussein, S. H., Ali, H. O., Kakamad, F. H."Granulomatous mastitis with erythema nodosum: A case report and mini‑review of the literature". World Academy of Sciences Journal 7, no. 6 (2025): 114. https://doi.org/10.3892/wasj.2025.402
Copy and paste a formatted citation
x
Spandidos Publications style
Ahmed RS, Salih AM, Pshtiwan LR, Muhialdeen AS, Salih KM, Ahmed MK, Dhahir HM, Hussein SH, Ali HO, Kakamad FH, Kakamad FH, et al: Granulomatous mastitis with erythema nodosum: A case report and mini‑review of the literature. World Acad Sci J 7: 114, 2025.
APA
Ahmed, R.S., Salih, A.M., Pshtiwan, L.R., Muhialdeen, A.S., Salih, K.M., Ahmed, M.K. ... Kakamad, F.H. (2025). Granulomatous mastitis with erythema nodosum: A case report and mini‑review of the literature. World Academy of Sciences Journal, 7, 114. https://doi.org/10.3892/wasj.2025.402
MLA
Ahmed, R. S., Salih, A. M., Pshtiwan, L. R., Muhialdeen, A. S., Salih, K. M., Ahmed, M. K., Dhahir, H. M., Hussein, S. H., Ali, H. O., Kakamad, F. H."Granulomatous mastitis with erythema nodosum: A case report and mini‑review of the literature". World Academy of Sciences Journal 7.6 (2025): 114.
Chicago
Ahmed, R. S., Salih, A. M., Pshtiwan, L. R., Muhialdeen, A. S., Salih, K. M., Ahmed, M. K., Dhahir, H. M., Hussein, S. H., Ali, H. O., Kakamad, F. H."Granulomatous mastitis with erythema nodosum: A case report and mini‑review of the literature". World Academy of Sciences Journal 7, no. 6 (2025): 114. https://doi.org/10.3892/wasj.2025.402
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