Recurrent Axillary Epidermal Cyst Extending into the Interpectoral Space, 30 Years after Initial Surgical Resection—A Case Report—

Abstract

A 57-year-old woman underwent incisional drainage of an axillary inflammatory epidermal cyst (1 cm) at 17 years of age. She developed recurrent infection at 26 years of age, and the mass was resected under local anesthesia. Histopathological examination of the resected specimen confirmed diagnosis of an epidermal cyst. She observed a recurrent left axillary mass in her 30s ; however, she did not seek medical attention at that time. Breast cancer screening mammography performed at 57 years of age revealed a huge left axillary mass, and she visited the hospital for evaluation. Body surface ultrasonography and computed tomography revealed a large axillary multilocular cyst (12 cm in diameter), with partial extension into the interpectoral space. The patient underwent resection of the mass under general anesthesia ; histopathological evaluation of the resected specimen showed an epidermal cyst, with a high index of clinical suspicion for recurrence of the mass resected 30 years earlier. Recurrent epidermal cysts are common in clinical practice, although no report has described recurrent axillary epidermal cysts adherent to deeper tissues with extension into the interpectoral space. This case report highlights that resection of even a small but recurrent epidermal cyst can be challenging.