Diagnosis and management of retroareolar cysts in adolescents: a case report
A healthy 15-year-old girl presented to her GP with mastalgia and periareolar cellulitis of her right breast. She was initially treated with a course of oral flucloxacillin but after 2 days there was no improvement and an emergency hospital referral was organized. Physical examination identified periareolar erythema in the presence of a tender subareolar inflammatory mass and a mild pyrexia. A provisional diagnosis of retroareolar abscess was made and an ultrasound scan (USS) was requested. The USS revealed three focal fluid collections or cysts located behind the nipple which were in direct communication with each other. The cysts contained echogenic fluid with surrounding hyperaemia and subcutaneous oedema. After conversation with a consultant breast surgeon, it was decided not to aspirate the mass but to discharge the patient on an additional course of amoxicillin and follow her up 3 days later with consultant review.\nSubsequent review revealed a mild improvement in symptoms and an alternative diagnosis of retroareolar cyst established. Follow-up with repeat USS 2 days later revealed a well-defined anechoic lesion cystic in nature rather than abscess. The lesion had decreased in size, and clinical examination revealed no existing erythema and decreased tenderness on palpation of the inflammatory mass.