Un adénofibrome kystisé se révélant par un tableau de mastite infectieuse en post partum

We report the case of Ms. A.A, a primiparous woman aged 21 years presenting (4 months after delivery) with an increase in left breast volume occurred 1 week after delivery associated with fever. The patient was put on amoxicillin, protected by suspending breast-feeding for several weeks without improvement. Clinical examination showed febrile patient with a temperature of 39°, an increase in left breast volume, inflammatory signs especially at the level of internal quadrants (A). Palpation showed a painful, hot collection adherent to the skin, measuring 16 cm, at the level of the internal quadrants, invading the external quadrants, without axillary adenopathies, suggesting breast abscess. Ultrasound (B) showed voluminous solidocystic predominantly liquid echogenic mass with thick walls and buds up to 46 mm, classified as ACR4. Puncture biopsy collected grayish green liquid, sent for bacteriological examination; antibiotic therapy with quinolones was started. Follow up of patient, after 3 days, showed reduction of the inflammatory signs and bacteriological examination of the liquid found no germ. After 15 days of antibiotic therapy, the inflammatory signs had disappeared and the volume of the mass had reduced enough, hence the indication for cystectomy. Cystectomy with simple enucleation was performed (C); surprisingly, the histological examination showed cystic fibroadenoma (D).