Axillary chyloma/seroma

Case contributed by Henry Knipe
Diagnosis certain

Presentation

Left axillary mass two years after wide local excision for invasive ductal carcinoma in the left breast.

Patient Data

Age: 67
Gender: Female
ultrasound

In the left axilla subcutaneous tissue related to the scar is an avascular cystic lesion with a fluid-fluid level. No suspicious or enlarged axillary lymph nodes.

Case Discussion

This has an unusual appearance with a fluid-fluid level in a cystic structure. Consideration was given to a hemorrhagic cyst but this would be unusual given the breast surgery was more than two years ago.

The cyst, which was located close to the surgical scar, was aspirated under ultrasound guidance with thick white fluid aspirated from the solid dependent portion and clear serous fluid from the anechoic portion - this confirms this as a chyloma/seroma. 

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