Clinical presentation and long-term follow-up of 45 patients with Mondor disease: A single-center longitudinal study

Mondor disease is characterized by an acute painful thrombophlebitis occurring at specific anatomical sites. Data on its incidence, characteristics of clinical presentation, and course are unavailable to date. We studied the course of Mondor disease in patients diagnosed and followed at the University Hospital Zurich (Switzerland) between 2004 and 2020. The primary study outcomes were a diagnosis of active cancer either at the time of clinical diagnosis of Mondor disease or within 1 year, as well as 1-year all-cause death and recurrent Mondor disease. We included 45 patients and classified them into one of the three Mondor disease subgroups: thoracic ( n = 26), penile ( n = 12), or axillary ( n = 7). The median age was 39 (Q1–Q3: 30–45) years and 44% of patients were men. Surgery was the likely cause of Mondor disease in 53.8% of patients with a thoracic form, 41.7% of those with a penile location, and all of those with an axillary location. Known active cancer was present in nine (20%) of 45 patients at baseline. One-year follow-up was available for 43 patients (median 94 months), whereas 6-month data were available for the remaining two patients. During the available follow-up, no patient had a new diagnosis of cancer. In conclusion, one in five patients with Mondor disease had known cancer at the time of diagnosis. During follow-up, the rate of new cancer diagnosis and death was negligible, providing reassurance about the good prognosis of this condition. Based on these preliminary data, extended cancer screening besides what is recommended by current guidelines for the general population might not be necessary in patients with Mondor disease.

COVID-19 Era: Mondor’s disease and Rembrandt. What ties?

The recent and increased number of scientific reports on venous thrombosis and venous thromboembolism induced by corona- virus, suggests to improve our level of attention because thrombophlebitis could be a clinical manifestation of COVID-19. We need to be aware also of rare varieties of venous thrombosis such as Mondor disease. The comparison between the enigmatic breast discoloration of the Bathsheba painted by Rembrandt and a case of Mondor disease observed in 2020, becomes a cultural game to improve our clinical skills in diagnosing Mondor thrombophlebitis.

Thrombophlebitis (Mondor Disease)

This chapter, appearing in the section on nipple, skin, and lymph nodes, reviews the key imaging and clinical features, imaging protocols and pitfalls, differential diagnosis, and clinical recommendations of superficial thrombophlebitis of the breast and anterior chest wall (Mondor disease). The condition is quite rare; incidence rates in the literature are reported as being less than 0.1%. Mondor disease is often temporally associated with a history of recent breast surgery, core needle biopsy, inflammatory process, or episode of trauma. Topics in this chapter include discussions of the incidence of Mondor disease, its presumptive pathophysiology, typical and atypical clinical/imaging presentations, and management considerations.