Serviço de Mastologia, Hospital Materno Infantil, Goiânia-GOObjective: to report a case of mastitis in the first clinical manifestation of acute myeloid leukemia (AML). Case report: a 59-year-old woman admitted to the emergency room of the Maternal and Child Hospital of Goiânia, reporting asthenia and left breast injury started 10 days ago. At clinical examination: pale, afebrile; left breast: extensive necrotic area, fetid odor and purulent secretion, measuring 15.0×8.0 cm. Laboratory tests revealed anemia and leukopenia, requiring blood transfusions. The cause of leukopenia was investigated. The patient underwent intravenous antibiotic therapy and surgical debridement. BAAR and HIV negative research. Bone marrow biopsy and myelogram were also performed. CT of the thorax showed left breast enlargement, skin and subcutaneous thickening; nodular opacity with soft tissue density in the left upper lobe; heterogeneous lesion of spiculated contours and areas of central necrosis located at the right pulmonary apex, suspected of secondary implants. MRI of the abdomen showed hepatic hemangioma in segment VII. After debridement, the anatomopathological study showed necrotizing dermatitis and panniculitis; content of adipose tissue with mixed inflammatory infiltrate, in addition to a small focal area with atypical ductal hyperplasia. Myelogram and immunophenotyping showed hypercellular bone marrow with 67% of type II blasts, moderate dyserythropoiesis and dysgranulopoiesis, increase of typical plasma cells. Findings compatible with AML. During hospitalization, the patient had other infections such as acute otitis media and urinary tract infection. She was referred for AML treatment at another service. Approximately 20 days after the start of chemotherapy, she had hemorrhagic stroke, and died. Conclusions: this is a case of AML whose initial clinical manifestation was in the breast. The mastologist should be familiar with the systemic diseases that may manifest in the breast to make the appropriate differential diagnosis.mastitis, acute myeloid leukemia
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