Abstract:
Background: Suppurative hidradenitis of the breast is an uncommon and diagnostically challenging condition that frequently mimics infectious mastitis or inflammatory breast carcinoma. Its atypical and recurrent nature often leads to extensive diagnostic workups and unnecessary interventions.
Methods: A 59-year-old woman presented to the Emergency Surgery Department with a painful, indurated mass of the left breast accompanied by erythema and localized warmth. Her medical history included multiple prior incisions and drainages of bilateral breast abscesses, all yielding negative cultures and negative histopathologic findings. Clinical assessment included focused breast examination, ultrasonography, inflammatory markers, and urgent incision and drainage. Samples were submitted for microbiology, cytology, and histopathology.
Results: Intraoperative findings revealed extensive purulent material with chronic inflammatory tissue consistent with hidradenitis suppurativa. Microbiological cultures were repeatedly negative, reflecting the known low pathogen detection rate in this condition. Histopathology demonstrated chronic non-specific inflammation without malignancy or granulomatous disease. The patient received targeted antibiotic therapy, wound care, and structured follow-up, leading to gradual clinical improvement.
Conclusions: Breast hidradenitis is a deceptively complex clinical entity that can closely resemble malignant or infectious processes. Recurrent inflammatory foci with negative cultures and non-specific histology require high clinical suspicion and multidisciplinary evaluation. Early recognition prevents unnecessary procedures, facilitates targeted management, and improves outcomes. This case highlights the need for heightened awareness of this under-recognized pathology among emergency and breast surgeons.
Biography:
Christos Simoglou MD, MSc, PhD completed his residency training in General Surgery at Komotini General Hospital, actively participating in and performing a large number of surgical procedures, with additional postgraduate training in the United States (Zuckerberg San Francisco General Hospital – Department of General Surgery & Trauma). He was fully involved in all clinical activities of the department and also provided coverage in the Intensive Care Unit (ICU).
Subsequently, within the framework of his specialist training for the acquisition of the Thoracic Surgery specialty, he focused exclusively on Cardiac and Thoracic Surgery at the University General Hospital of Evros, where he gained extensive experience in both emergency and elective cases. He assisted in a large number of procedures and also served as the primary surgeon in major open-heart and thoracic surgeries.
Concurrently, he participated in the on-call rota of the department and served as a key member of the Intensive Care Unit, where he acquired comprehensive expertise in the management of postoperative cardiac and thoracic surgery patients, including mechanical ventilation and the use of the intra-aortic balloon pump (IABP), gaining substantial experience in postoperative critical care monitoring.
He served as an Assistant Consultant (Grade B) in Cardiac Surgery at the University General Hospital of Heraklion, Crete, where he consistently participated in the on-call program of the Cardiac Surgery Department, in surgical procedures, and in the management of critically ill cardiothoracic patients in the ICU and Emergency Department. He also undertook on-call duties in the Thoracic Surgery Department, participated in thoracic surgical procedures, and covered the full spectrum of medical acts in the Cardiac Intensive Care Unit.
He later served as Head of the Cardiac Surgery Department and the Cardiothoracic Intensive Care Unit at Hippocratio General Hospital of Athens, practicing as a Cardiac Surgeon.
He further served as a Postgraduate Fellow in Cardiac Surgery at the Second Cardiac Surgery Department of Heart and Lung Transplantation and Mechanical Circulatory Support at the Onassis Cardiac Surgery Center, Athens.
Additionally, he served as an Assistant Thoracic Surgeon at the Korgialenio–Benakio General Hospital of Athens, Hellenic Red Cross. In the field of Thoracic Surgery, beyond conventional open and thoracoscopic procedures, he specializes in advanced techniques such as pectus excavatum repair, with continuous postgraduate training abroad in Europe (UK) and the United States, including the Thoracic Surgery Clinic at UW Medical Center – Montlake, Seattle, USA.
He has authored more than 100 medical articles, abstracts, and presentations published in Greek and international journals, and has participated in a large number of national and international medical scientific conferences, contributing to scientific publications and research projects in Europe and the United States.
