Metaplastic squamous cell carcinoma caricaturing as tuberculous mastitis-A vicissitude of clinical diagnostic misadventure

Abstract

Tuberculous mastitis and invasive breast cancers are known to co-exist or occur in the breast independently of each other, albeit the former being less common in developed countries. Tuberculous mastitis with its clinical presentation and morphological features can caricature invasive breast carcinoma. The overlapping features of tuberculous mastitis and metaplastic squamous cell carcinoma often lead to, if no due clinical diligence and discretion is used, bewildering misinterpretation with the vicissitude of diagnostic implications of tuberculous mastitis ensuing catastrophic and perilous ramifications. A 42-year-old woman presented with exophytic growth with extensive areas of ulceration. Clinically, the lesion was diagnosed as disseminated tuberculous mastitis based on clinical and morphological features, which was surgically resected. On histological examination, the lesion was diagnosed as invasive metaplastic squamous cell carcinoma. Thecase being presented here displays the vagary involved in clinical diagnosis of tuberculous mastitis inasmuch as it often shares clinical and morphological features with a devastatingly perilous variant of invasive duct carcinoma, metaplastic squamous cell carcinoma, the inadvertent eschewing of or misapprehending of which may engender devastating prognostic implications.