Primary hydatid disease of the breast clinically masquerading as a galactocele: A case report

We report a rare case of a 30-year-old breastfeeding woman who presented to our surgical outpatient department with complaints of a gradually enlarging lump in her left breast for the last 2 months. She also complained of difficulty in breastfeeding for 1 week. On examination, the right breast was normal but there was a 4 cm × 4 cm retroareolar soft lump in her left breast. Examination of the bilateral axilla was normal. A provisional diagnosis of galactocele was made and the patient was subjected to ultrasonic mammography and fine needle aspiration cytology (FNAC). Ultrasonic mammography of the left breast showed a heterogeneous, hypoechoic lesion with thick septations and internal echoes suggestive of a complex cystic lesion, leading to a differential diagnosis of either hydatid cyst or breast abscess. On FNAC, the aspirate was not milky and cytological examination was performed, which revealed hydatid scolices, hooklets, foamy macrophages and granular debris, leading to the final diagnosis of hydatid cyst of the breast. The patient was investigated further but there were no cysts at any other site. Chemotherapy with albendazole was started and surgery was performed after 1 month. Histopathology further confirmed the diagnosis. Owing to the rarity of presentation, this case is being reported here.