Factitious disease of the breast of a male due to injection of liquid plastic


Ted Rosen, MD, 2815 Plumb, Houston, TX 77005, USA
E-mail: TedRosenMD@aol.com


Background  Factitious disease involving the breast is unusual. The rarely reported cases of this entity have been encountered in middle-aged women. In general, factitious disease can be distinguished on clinical and/or psychological grounds from self-induced disorders seen in malingerers and among those demonstrating Munchausen's syndrome.

Methods  We report herein a male patient displaying factitious disease of the breast due to injection of a high viscosity liquid plastic material.

Results  Establishment of the proper diagnosis was greatly delayed due to a lack of suspicion of this entity. Only direct confrontation of the patient with the biopsy results (lipogranulomatosis) led to a reluctant and then only partial admission of the self-induced nature of this patient's illness.

Conclusion  The clinician should remain vigilant for factitious disease when confronted with chronic or recurrent lesions of a bizarre or atypical morphology. Any body site can be involved, including the breast. Management is difficult and is best accomplished in conjunction with an appropriate mental health professional. Continued dramatic surgical interventions are contraindicated.