Necrotising fasciitis in a patient with monoclonal gammopathy of undetermined significance.

To consider the potential risk of an unprovoked infectious disease, such as necrotising fasciitis, being present in patients whereby monoclonal gammopathy of undetermined significance is an active co-morbidity.

Can we see what is invisible? The role of MRI in the evaluation and management of patients with pathological nipple discharge.

Introduction: The aim of this study was to determine the ability of MRI to identify and assess the extent of disease in patients with pathological nipple discharge (PND) with an occult malignancy not evident on standard pre-operative evaluation with mammography and ultrasound.

Methods: Patients presenting to the breast unit of Imperial College Healthcare NHS Trust between December 2009 and December 2018 with PND and normal imaging were enrolled in the study. Pre-operative bilateral breast MRI was performed in all patients as part of our protocol and all patients were offered diagnostic microdochectomy.