Primary invasive ductal carcinoma of axillary accessory breast.

Primary accessory breast cancer is an extremely rare pathology, representing less than 1 % of all breast cancers, and it is found in more than 90 % of cases in the axilla. The diagnosis of accessory axillary breast cancer (AABC) is often late and at an advanced stage with an average delay of 40.5 months. Histological sampling and immunohistochemical results confirm the diagnosis. Most patients are diagnosed with stage II disease or higher, so it is considered to have a poor prognosis. There is no specific management for AABC; it follows the guidelines for orthotopic pectoral breast cancer. We therefore report the case of a 50-year-old woman diagnosed with grade II invasive ductal carcinoma found in accessory axillary breast, treated by wide local resection and sentinel lymph node dissection.

Persistent Left Superior Vena Cava Associated with Right Aberrant Subclavian Artery Detected during Totally Implantable Vascular Access Device Insertion.

Introduction Persistent left superior vena cava (PLSVC) is a rare vascular malformation, with several cases reported in the English literature. The diagnosis is made incidentally, during cardiovascular imaging or when a catheter is placed in the left jugular or subclavian vein. They are without associated hemodynamic alterations, except if they have left atrial drainage or an associated dilation of the coronary sinus. If necessary, long-term PSLVC catheterization with right atrial drainage is safe. Case Presentation We report the case of 40-year-old man, admitted for placement of totally implantable vascular access device (TIVAD) on the same day of his first chemotherapy. A disease localized to the right neck made it impossible to puncture on the right. During the puncture of the left internal jugular vein, the diagnosis of PLSVC was made. Postoperative investigations confirmed the diagnosis and showed the presence of the right superior vena cava to which it was connected by the left brachiocephalic vein. They also confirmed the drainage of PLSVC into the coronary sinus. In addition, they demonstrated the presence of an associated right aberrant subclavian artery of direct aortic origin. Chemotherapy was administered safely and the port was removed 9 months after insertion without any problem. Conclusion This is one of the rare cases reported in the English literature of PLSVC diagnosed during TIVAD insertion and the first to report an associated vascular malformation. We publish it to encourage physicians to think about this differential diagnosis and to carefully perform the appropriate investigations before using the port.

Primary Breast Tuberculosis Mastitis Manifested as Nonhealing Abscess.

Primary breast tuberculosis (TB) is a rare extrapulmonary TB mainly affecting young women of childbearing age from endemic countries. Its incidence is increasing in immunocompromised and HIV-infected people and with the emergence of drug-resistant strains of Mycobacterium tuberculosis (MTB). There are no specific clinical signs suggestive of this disease, it often presents as a hard mass or breast abscess. There is an overlap of features with other inflammatory, infectious, benign lesions, fat necrosis and malignant neoplasms of the breast. The detection of MTB remains the gold standard for diagnosis. Several other diagnostic modalities are used, with varying lack of sensitivity and specificity, and with a range of false negatives. A quarter of cases were treated solely on the basis of clinical, imaging or histological suspicion, without confirmation of the diagnosis. Therefore, we report the case of a young Vietnamese woman, presented for a nonhealing breast abscess, and diagnosed with breast TB based on the patient's ethnicity, histological findings, lack of clinical response to conventional antibiotic therapy, and a good clinical response to anti-TB treatment.