Asian Journal of Case Reports in Surgery

Aim: Tuberculosis (TB) of the breast presenting as a cold abscess is a rare condition. We present here such a case of a young female patient with a left breast lump and a history of pulmonary tuberculosis on Antitubercular therapy (ATT) treatment. The presence of a cold abscess was confirmed by ultrasound and CT scan, surgical drainage of the abscess was done and ATT was continued. The patient showed satisfactory recovery and had been doing well by one month.

Presentation of Case: A 25 year old female presented with a painless left breast lump for eight months. She was diagnosed with pulmonary tuberculosis four months back and was on Antitubercular therapy since then. Ultrasound of breast revealed abscess collection. Surgical drainage for the cold abscess was done and a biopsy sample from the abscess wall revealed the presence of epitheloid granuloma and giant cells. The patient recovered well with ATT continued.

Discussion: Being a rare entity, cold abscess of breast secondary to Koch’s etiology may often get misdiagnosed as other benign breast lesions such as fibroadenoma. However judicious radiological and pathological workup may help in timely diagnosis and treatment for the same. ATT treatment holds a key for early recovery. Surgical drainage for a cold abscess may be required on case to case basis.

Conclusion: This case report demonstrates the importance of timely clinical diagnosis in cases with tuberculous cold abscess of the breast.