Seroma formation is the most frequent complication of modified radical mastectomy for carcinoma of the breast and occurs in up to 35% of all patients undergoing mastectomy with lymph node dissection. Although various managements and risk factors for seroma formation have been previously reported, little has been published concerning seroma with fibrous capsule formation which ultimately requires a surgical resection.
We herein present a case who developed axillary contracture which severely restricted arm abduction due to seroma with fibrous capsule formation after mastectomy and axillary lymph node dissection.
Attempts to correct the deformity with scar contracture release was unsuccessful. During these procedure, a thick fibrous seroma capsule was found that was adherent to axillary subcutaneous adipose tissue and severely limited abduction of the arm. The patient underwent resection of the fibrous seroma capsule and limited abduction of the arm was improved to nearly full range of motion postoperatvely.
In conclusion, seroma formation after modified radical mastectomy and axillary dissection seems to cause a severe contracture of axilla, and it thus appears that the prevention of prolonged seroma formation is important to reduce the occurrence of axillary contracture.