A 35-year-old patient with skin phototype I according to the Fitzpatrick classification who came to the Plastic Surgery Department of our hospital with a family history of fibrocystic mastopathy and intracanal papillomatosis.
Mammography showed well distributed micronodular tissue that was classified as BIRADS 3 mammographic pattern.
However, she was admitted for prophylactic surgery for breast cancer.
There were no palpable axillary lymph nodes at the time of surgery.
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A conservative bilateral skin mastectomy was performed, with intraoperative finding of a black axillary lymphadenopathy close to the subcutaneous tissue.
The possibility of finding metastases from melanoma intraoperatively remits the sample for pathological study in a deferred manner.
We did not find other clinical signs suggestive of tumor pathology, so we ended the surgery with bilateral breast prosthesis placement.
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A thorough examination of the patient during the postoperative period revealed no cutaneous lesions consistent with melanoma, but the presence of a tattoo in the left pectoral region of 10 years of age.
The patient was discharged awaiting the results of the Pathological Anatomy study.
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The histological examination of the surgical piece revealed adenopathy as a fragment of bilobulated appearance and violet color, 1.6 x 1.3 x 0.5 cm., of violet dye.
Lipid-reactive hyperplasia was diagnosed at the junction.
The structure of the ganglion was conserved, without presence of leukocytes and deposition of a dark granular artificial pigment.
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Once again in the consultation, the clinical examination along with the histological study of the lesion allowed attributing the cause of the clinical changes of adenopathy to the patient's tattoo, with the consequent result of an injury or follow-up without further treatment.
