Multimodality Imaging of Charcoal Granuloma Mimicking Breast Cancer Recurrence

Charcoal is a biologically inert material used for the preoperative localization of nonpalpable breast lesions; its foreign body reactions have occasionally been reported. Although a few case reports on the formation of charcoal granulomas in the breast because of such reactions exist, to the best of our knowledge, no report includes breast-imaging findings obtained using multiple modalities. Here we report a case of two charcoal granulomas that mimicked breast cancer recurrence and provide breast-imaging findings obtained using mammography, ultrasonography, magnetic resonance imaging, and positron emission tomography/computed tomography. We also discuss the radiological and pathological features of charcoal granulomas. Awareness of breast imaging findings using multiple modalities along with the clinical and pathological features of charcoal granulomas helps in the differential diagnoses of newly detected lesions on postoperative follow-ups and reduces the need of unnecessary invasive procedures.