Local heparin, superficial vein thrombosis

Mondor’s Disease: A Rare Cause of Chest Pain

Mondor’s disease is an uncommon cause of breast and chest pain. It is characterized by cord-like thickening of the superficial veins of the anterior chest wall mimicking many life-threatening illnesses such as pulmonary thromboembolism and myocardial infarction. The disease may have been caused by trauma, other hypercoagulable states, or underlying breast diseases such as infection or carcinoma breast, but, in most cases, its etiology remains unknown. Mondor’s disease is usually self-limited and can be managed conservatively. Although a rare and benign diagnosis, Mondor’s disease should be a part of the differentials of chest pain, and its diagnosis can be made on the basis of a thorough clinical examination alone, which reduces not only costs but also the risks of further testing for patients presenting with chest pain.

We highlight the case of a 40-year-old premenopausal female patient who presented to the outpatient department with stretching aching chest pain on the left side, which got aggravated on movements of the arm and relieved on rest.

Mondor’s disease is not considered a differential diagnosis for chest pain due to a lack of awareness about it. Creating awareness of this condition through this case report would help to reduce unnecessary investigations and valuable time spent and would help identify a serious underlying cause, especially early stage carcinoma of the breast.

Mondor's disease - a rare cause of chest pain: a case report

BACKGROUND

Chest pain is one of the common presenting symptoms encountered in an emergency department. Prompt history taking and careful clinical examination do help to differentiate cardiac chest pain from other causes. Mondor's disease is a rare cause of chest pain which is often underdiagnosed due to lack of awareness. Mondor's disease is a condition characterized by thrombophlebitis of the superficial veins of breast and anterior chest wall. The diagnosis is often made clinically.

CASE PRESENTATION

Here we report a case of a 37-year-old Sri Lankan Tamil woman who presented with chest pain and was clinically diagnosed as having Mondor's disease after a physical examination, which was confirmed with demonstration of thrombophlebitis by ultrasound scan imaging. Although it is a self-limiting condition, non-steroidal anti-inflammatory drugs are used in the treatment to hasten recovery in addition to giving reassurance.

CONCLUSIONS

Mondor's disease is not considered a differential diagnosis for chest pain due to lack of awareness of this medical condition. Creating awareness of this condition via this case would help to cut down unnecessary investigations and valuable time spent in emergency departments, and it helps to identify a serious underlying cause especially carcinoma of the breast at its early stage.

Mondor's disease in a patient after a mammotome biopsy

Mondor's disease is a rare, benign condition characterised by thrombophlebitis affecting subcutaneous veins of the chest and/or abdomen without an accompanying inflammatory response. The disease has a multifactorial etiology and its course is benign. It is usually self-limiting or it is eliminated by local treatment. Mondor's disease in the thoracoepigastric region may be a rare complication of mammotome biopsy. The case presentation describes a 32-year-old patient with Mondor's disease in the thoracoepigastric region after an ultrasound-guided mammotome biopsy of a breast. In the histopathological examination the lesion was diagnosed as fibroadenoma. Regardless of the disease's etiology, it is recommended to carry out diagnostic examinations to exclude co-occurring breast cancer.

Superficial thrombophlebitis (Mondor's Disease) after breast augmentation surgery

Although the aetiology of Mondor's disease remains unclear, the most commonly cited cause is trauma of some sort. Although surgical trauma has frequently been quoted, reports that specifically implicate aesthetic breast surgery are unusual in the literature. In this article, the authors report a case of superficial thrombophlebitis of the anterolateral chest wall secondary to breast augmentation surgery in a woman, five months after the procedure. The authors performed an analysis of the disease's main etiologic components and preponderant clinical aspects, and determined all appropriate therapeutic measures.