The Great Mimicker: Zona Zoster at the Mastectomy Site Causing Contralateral Intramammary Lymph Node Enlargement

Zona zoster is rarely observed in patients with malignancy; when present, it follows a dermatomal fashion. Involvement of widely separated regions is very rare. Hereby, zona zoster causing enlarged intramammary lymph nodes (IMLN) in the opposite breast is reported for the first time in literature. T...

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Main Authors: Umit Aksoy Ozcan, Evrim Tezcanli, Yesim Yildirim, Melahat Garipagaoglu
Format: Article
Language:English
Published: Wiley 2012-01-01
Series:Case Reports in Oncological Medicine
Online Access:http://dx.doi.org/10.1155/2012/468576
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author Umit Aksoy Ozcan
Evrim Tezcanli
Yesim Yildirim
Melahat Garipagaoglu
author_facet Umit Aksoy Ozcan
Evrim Tezcanli
Yesim Yildirim
Melahat Garipagaoglu
author_sort Umit Aksoy Ozcan
collection DOAJ
description Zona zoster is rarely observed in patients with malignancy; when present, it follows a dermatomal fashion. Involvement of widely separated regions is very rare. Hereby, zona zoster causing enlarged intramammary lymph nodes (IMLN) in the opposite breast is reported for the first time in literature. The masses were hypoechoic on US with no hilum and hypervascular on color Doppler US. MRI showed hypointense masses with type 3 time-intensity curve and adjacent vessel sign. The complete regression of the nodes after the antiviral therapy confirmed the diagnosis. In breast cancer patients, IMLN enlargements may mimic breast cancer metastasis, and zona zoster infection of the mastectomy site may present with contralateral IMLN enlargement due to altered lymphatic drainage. When breast US is not sufficient for the differential diagnosis, breast MRI may warrant proper diagnosis, and prevent unnecessary biopsies. Antiviral treatment with followup would be sufficient for management.
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issn 2090-6706
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publishDate 2012-01-01
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spelling doaj-art-c97d73508d2d41fabb808ca7e12527032025-08-20T03:19:34ZengWileyCase Reports in Oncological Medicine2090-67062090-67142012-01-01201210.1155/2012/468576468576The Great Mimicker: Zona Zoster at the Mastectomy Site Causing Contralateral Intramammary Lymph Node EnlargementUmit Aksoy Ozcan0Evrim Tezcanli1Yesim Yildirim2Melahat Garipagaoglu3Department of Radiology, Acibadem University School of Medicine, Istanbul, TurkeyDepartment of Radiation Oncology, Acibadem University School of Medicine, Istanbul, TurkeyDepartment of Medical Oncology, Anatolian Health Center Hospital, Istanbul, TurkeyDepartment of Radiation Oncology, Acibadem University School of Medicine, Istanbul, TurkeyZona zoster is rarely observed in patients with malignancy; when present, it follows a dermatomal fashion. Involvement of widely separated regions is very rare. Hereby, zona zoster causing enlarged intramammary lymph nodes (IMLN) in the opposite breast is reported for the first time in literature. The masses were hypoechoic on US with no hilum and hypervascular on color Doppler US. MRI showed hypointense masses with type 3 time-intensity curve and adjacent vessel sign. The complete regression of the nodes after the antiviral therapy confirmed the diagnosis. In breast cancer patients, IMLN enlargements may mimic breast cancer metastasis, and zona zoster infection of the mastectomy site may present with contralateral IMLN enlargement due to altered lymphatic drainage. When breast US is not sufficient for the differential diagnosis, breast MRI may warrant proper diagnosis, and prevent unnecessary biopsies. Antiviral treatment with followup would be sufficient for management.http://dx.doi.org/10.1155/2012/468576
spellingShingle Umit Aksoy Ozcan
Evrim Tezcanli
Yesim Yildirim
Melahat Garipagaoglu
The Great Mimicker: Zona Zoster at the Mastectomy Site Causing Contralateral Intramammary Lymph Node Enlargement
Case Reports in Oncological Medicine
title The Great Mimicker: Zona Zoster at the Mastectomy Site Causing Contralateral Intramammary Lymph Node Enlargement
title_full The Great Mimicker: Zona Zoster at the Mastectomy Site Causing Contralateral Intramammary Lymph Node Enlargement
title_fullStr The Great Mimicker: Zona Zoster at the Mastectomy Site Causing Contralateral Intramammary Lymph Node Enlargement
title_full_unstemmed The Great Mimicker: Zona Zoster at the Mastectomy Site Causing Contralateral Intramammary Lymph Node Enlargement
title_short The Great Mimicker: Zona Zoster at the Mastectomy Site Causing Contralateral Intramammary Lymph Node Enlargement
title_sort great mimicker zona zoster at the mastectomy site causing contralateral intramammary lymph node enlargement
url http://dx.doi.org/10.1155/2012/468576
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