Bilateral Male Idiopathic Granulomatous Mastitis of the Breast: a Case Report

Idiopathic granulomatous mastitis (IGM) is a rare benign inflammatory disease of the breast of unclear etiology, which can mimic breast cancer or infection. It is usually seen in parous women and is very seldom seen in males, with a few reported cases in the literature. We report a rare case of a 46 -yearold male presenting with bilateral breast lumps and left -sided peri-areolar discharge from sinus tracts, who had failed antibiotic treatment. Bilateral mammogram, ultrasound, and core needle biopsies of the breast masses were performed, which revealed pathological findings consistent with granulomatous mastitis. The case was reported as bilateral IGM after exclusion of all known secondary causes of the disease, specifically tuberculosis and corynebacteria infection, as well as autoimmune diseases. To the best of our knowledge, this is the first case presentation of bilateral IGM in a male. Our patient was treated pharmacologically, initially using corticosteroids followed by methotrexate, and demonstrated good response with decreased swelling bilaterally and resolution of left peri-areolar discharge. Therefore, similar to women, IGM can present with bilateral disease in males. It is important for clinicians to be aware of IGM and its presentation in males to be able to correlate typical clinical findings with imaging and biopsy in order to avoid extended antibiotic therapy.