A case report of a bullet in the breast of a woman for four years without any complications. (April 2023) - Al Horani, Osama
Abstract: Introduction and importance: A bullet stabilized in a breast for more than 4 years without causing any complication due to its presence is not a common case. Sometimes breast isolated injury could be seen without symptoms like pain, or palpable mass, or it could present with abscess formation and fistula. In addition, the bullet – if it's small ‐ could mimic calcifications seen in malignancy when performing mammography. Case presentation: We report a case of a 46-year-old well-being female who came to resect a superficial gunshot she got in her left breast in one of the armed conflict areas in Syria. The bullet has been settled there for more than 4 years without causing any inflammation-related signs at the wound's site and without causing any symptoms or complications. Clinical discussion: The tissue damage caused by the gunshot is associated with several factors such as the bullet caliber, speed, range of shooting, and energy flux. Frequently, gunshot injuries are most serious in friable solid organs like the liver and brain, whereas dense tissues such as bones and loose tissues like subcutaneous fat are more tolerant and resistant to that kind of insult. When a foreign body (bullet) enters the body without causing tremendous tissue damage and settles there for enough period of time we expect seeing signs of inflammation (heat, swelling, pain, tenderness, and redness). Conclusion: Such cases must be taken into consideration and not be neglected without intervention due to the increased risk of many fearful complications including Squamous Cell Carcinoma. Highlights: Gunshots are one of the many causes of granulomatous disease of the breast. Appearance on mammography can mimic calcifications seen in malignancy. Loose tissues like subcutaneous fat are more resistant to bullet injury.