Intermammary pilonidal sinus in an adolescent female: a case report

Abstract Background Pilonidal sinus disease typically occurs in the sacrococcygeal region, with the intermammary location being exceptionally rare. We report the first documented case of an intermammary pilonidal sinus from eastern India in a 14-year-old Asian female. Case presentation A 14-year-old Asian female presented with 1-year history of intermammary swelling that evolved into a discharging sinus after 11 months. Physical examination revealed multiple sinus tract openings in the intermammary region with surrounding induration. Complete excision of the sinus tract with primary closure was performed under general anesthesia. Histopathological examination confirmed chronic inflammatory tissue consistent with the pilonidal sinus. The patient had an uncomplicated recovery with no recurrence at follow-up. Conclusions Inclusion of intermammary pilonidal sinus in the differential diagnosis of chronic intermammary lesions should be considered, particularly in young females with large, pendulous breasts. Early recognition and complete surgical excision remain the gold standards for treatment, with excellent outcomes.