Mondor's disease is a rare and self-limited disease, which was first reported by Fage in 1870[1]. Due to its rarity, this disease is poorly understood. The reported sites are mainly in the anterior thoracic region, and few cases in the axillary region or penis.Studies reported the incidence of Mondor’s disease ranged from 0.07–0.96%[2]. Mondor’s disease always begins with a sudden onset of pain and a visible tenderness subcutaneous cord[3, 4]. The most common symptom is pain and local tenderness, and the most common sites are mammary region and the anterolateral wall of thorax[2, 5, 6]. Moreover, the affected veins include thoracic lateral vein, superior epigastric vein and the thoracoepigastric vein[7, 8]. The specific pathogenesis of Mondor’s disease is still unclear. Some reports have suggested that it may be associated with local trauma, surgery, infections, excessive exercise of the upper limbs[7, 9], cancer or hypercoagulability. A research revealed that MD was associated with primary or metastatic breast cancer[10], but it remains unproven. In view of this patient’s history, chronic hepatitis B, as well as excessive exercise of the upper limbs, may be two important causes for MD.
The main pathogenesis of MD is confirmed to be thrombophlebitis, and few is lymphangitis[11]. There are often two stages in the development of Mondor’s disease, namely acute inflammatory cell infiltration accompanied by thrombosis in the veins and connective tissue proliferation in the veins resulting in the formation of a hard cord [3, 4, 11]. The diagnosis of MD is usually based on history, physical examination and ultrasound findings. Robert et al.[6]found a high prevalence of active cancer and recent surgery when initially diagnosed with MD. However, imaging examinations, such as ultrasonography or CT examination, should be used to exclude malignancy or other mass compressing the veins [12]. Currently, there is no standard guideline for the treatment of MD. Most authors suggest nonsteroidal anti-inflammatory drugs (NSAIDs) should be the primary treatment. Surgery may be consider when symptomatic treatment is invalid, or in cases of relapsed, and thrombectomy or superficial vein resection may be performed[13]. Antibiotic therapy is not required only when there is proof of infection and systemic anticoagulation is not required, but it can be considered in the acute phase[14].
Due to the lack of enough evidence, the potential risk factors remain speculative. MD is often idiopathic. Symptoms including pain, tenderness and cord-like induration can completely resolve in 4–8 weeks without specific therapy[2]. A recent study revealed that there was no recurrence and a new cancer after treatment during one-year follow-up.