CT scan without IV contrast showed a large mass, again with a fluid-fluid level. The denser portion of the mass measured 60 HU, consistent with blood clot.

Facts:

* Common causes: post procedure (biopsy, surgery), direct trauma, coagulopathy
* Breast hematoma occurs in approximately 2% - 10% after breast surgery
* Risk factors: use of some medications (aspirin, NSAIDs, anticogulants)

US Findings:

* Depends on stage of blood product
* Clotted blood appears echogenic, lysed blood (serum) appears cystic.
* No internal flow


Our case - follow up ultrasound was performed and the mass has evolved into a lysed hematoma and then disappeared. Diagnosis was breast hematoma related to anticoagulant use.

Reference:
Vitug AF, Newman LA. Complications in breast surgery. Surg Clin N Am 2007;87:431-451.

Case submitted / courtesy of via RiT