BILATERAL, TUMOR-LIKE DIABETIC MASTOPATHY-PROGRESSION AND REGRESSION OF THE DISEASE DURING 5-YEAR-FOLLOW UP

Diabetic mastopathy is a recently described collection of radiographic al and histological features found in dense fibrous masses of the brea st in long standing Type I diabetes. We describe the first case of bil ateral disease with the alternate progression and regression of the di sease over a 5 year period. A 45-year-old woman has been affected of i nsulin dependent diabetes mellitus (IDDM) for 21 years. She developed palpable mass retromamillar of the right side, indistinguishable radio graphically from cancer. The histology showed a diabetic mastopathy (D MP) with B-lymphocytic ductitis and lobulitis, a discrete monocellular vasculitis and a keloid-like fibrosis. After 22 months she developed a suspicious palpable mass contralateral on the left side. The FNAB pr esented an identical morphology on histology. Additionally 10 months l ater there were no palpable masses of both mammae. Mammographically no suspect alterations were observed. One year later the clinical and ma mmographical examination showed similiar findings, mentioned before. T he pathogenesis is still obscure and includes the hypothesis of extrac ellular accumulation, secondary to prolonged hyperglycemia in IDDM, pr oduction of alternated non-enzymatic glycosylated end products with ne oantigen formation, B cell predominant inflammation with autoimmune re sponse against neoantigens and cytokine release secondary to the autoi mmune response. (C) 1998 Elsevier Science Ireland Ltd. All rights rese rved.