Clinical management and multimodal imaging features of brucellar mastitis mimicking metastatic breast carcinoma: a rare case report and literature review

Brucella mastitis represents a rare infectious disease that is frequently misdiagnosed as metastatic breast carcinoma, particularly when older women present with systemic manifestations. Here, we report a 60-year-old woman presenting with a neck pain and left upper extremity numbness. Initial contrast-enhanced magnetic resonance imaging (CEMR) and 18F-FDG PET-CT highly suggested breast malignancy with osseous metastasis, while contrast-enhanced ultrasound (CEUS) provided critical microvascular perfusion insights favoring an inflammatory process. The diagnosis was ultimately confirmed via blood culture and pathological examination. The patient was successfully treated with targeted antimicrobial treatment. This case offers important insights into the multimodal imaging differentiation of atypical breast lesions and emphasizes the diagnostic challenges of Brucella mastitis accompanied by systemic osteoarticular involvement.