59-year-old patient, rural resident, who lives in a poor region of Morocco endemic to tuberculosis., menopausal for 5 years, without particular pathological history, was not taking any drugs and with no medical family history, consults for swelling in the right breast The onset of symptoms goes back 5 months by autopalpation of a nodule in the right breast associated with a progressive increase in its volume associated two months later with a mastodynia, without nipple discharge, without local inflammatory sign.
Clinical examination shows 2 masses occuping the entire upper outer quadrant of the right breast, respectively 8 cm, 4 cm in diameter and prolapsing in the axillary region, of soft consistency, well limited, mobile and painless, without inflammatory phenomenon of the skin integuments opposite. There is no axillary or supraclavicular lymphadenopathy, nor nipple discharge (Fig. 1).
Radiological explorations (mammography + ultrasound) (Figs. 2, 3) carried out objectified:
the first measures 66 x 84 mm in transverse diameter and has a thin wall and anechoic content. classified ACR2 BIRADS.
The second measures 49 x 47 mm in transverse diameter in the axillary hollow and has ultimately echogenic content with a sloping portion producing the appearance of pseudo vegetation. classified ACR3 BIRADS.
A voluminous opacity of the QSE of the dense and well limited right breast corresponding on ultrasound to two cystic masses of the QSE and the right axillary hollow.
The two masses are not vascularized by Doppler.
An abdominal ultrasound, a chest x-ray, as well as a biological blood test (complete blood count, ionogram) performed are completely normal. A fine needle aspiration of the cyst only showed the presence of altered polynuclear, without evidence of tumor cells. Treatment consisted of surgical excision such as perikystectomy (Fig. 4) who was performed by junior resident with 5 years of specialised training, and pathology examination demonstrated breast hydatidosis.
Postoperative evolution was favourable. Patient was put on medical treatment based on albendazole immediately. The patient was monitored for one year without local or distant recurrences.