Traumatic haematoma of the breast

Case contributed by Dr Giorgio M Baratelli

Presentation

Blunt direct trauma to the right breast, 3 days ago. She is concerned of a painful lump of about 10 cm in the medial quadrants of the right breast. On clinical examination, the lump is hard, tender and not fluctuating, with ill-defined margins.

Patient Data

Age: 52 years
Gender: Female
Modality: Ultrasound

The breast ultrasound shows a 8 cm mixed echogenicity mass: clotted blood is echogenic, serum is detected as the anechoic area.

Modality: Photo

An extensive bluish discoloration of the skin of the breast is visible.

Case Discussion

The diagnosis of traumatic breast haematoma is easy due to history of a direct trauma and the ecchymotic suffusion of the skin. She has no history of coagulation disorders neither takes medications. The diagnostic blood tests (CBC, PT/INR, PTT) are normal.

It is important to keep in mind that:

  • haematoma may be related to a  coagulopathy or the use of some drugs (aspirin, NSAIDs, anticoagulants)
  • a hematoma without a history of trauma may be related to a tumor causing the hemorrhage
  • infection is a possible complication of hematoma

Treatment: haematomas should be surgically drained after bleeding is stopped if it is of large size or causing pain.

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Case Information

rID: 31615
Case created: 18th Oct 2014
Last edited: 10th Sep 2016
System: Breast
Inclusion in quiz mode: Included

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