Mondor Disease Clinical Presentation

  • Author: Robert A Schwartz, MD, MPH; Chief Editor: Dirk M Elston, MD   more...
 
Updated: May 27, 2011
 

History

Mondor disease is most often observed on the upper anterolateral aspect of the chest wall.[6] No systemic symptoms are present.

Ask the patient about the following:

  • Recent breast surgery: In one report, 7 of 15 patients had a radical mastectomy prior to the onset of Mondor thrombophlebitis on the ipsilateral side.[8] Mondor disease may occur after breast reduction surgery.[9]
  • Possibly, physical strain[10]
  • Tight dressings and tight-fitting bras[11]
  • Axillary shaving[12]
  • Blood dyscrasia[13]

Subcutaneous penile vein thrombosis (penile Mondor disease) has also been described.[2] It is first evident as sudden and almost painless indurations on the penile dorsal surface.

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Physical

Mondor disease has a characteristic clinical picture of a sudden appearance of a linear, cordlike, thrombosed vein. At first, this vein is red and tender, and then, it subsequently changes into a painless, tough, fibrous band. The cord is accentuated by traction, elevation of the breast, or abduction of the ipsilateral arm.

If the patient does not seek medical attention upon the initial presentation, the tenderness gradually subsides, while the thrombus organizes and recanalizes, leaving a nontender, hard, ropelike band. This band remains for varying periods up to several weeks.[3]

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Causes

See Pathophysiology.

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Contributor Information and Disclosures
Author

Robert A Schwartz, MD, MPH  Professor and Head, Dermatology, Professor of Pathology, Pediatrics, Medicine, and Preventive Medicine and Community Health, University of Medicine and Dentistry of New Jersey-New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American College of Physicians, and Sigma Xi

Disclosure: Nothing to disclose.

Coauthor(s)

Matthew J Trovato, MD  Fellow, Division of Plastic Surgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School

Disclosure: Nothing to disclose.

Specialty Editor Board

Julie C Harper, MD  Assistant Program Director, Assistant Professor, Department of Dermatology, University of Alabama at Birmingham

Julie C Harper, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Stiefel Honoraria Speaking and teaching; Allergan Honoraria Speaking and teaching; Intendis Honoraria Speaking and teaching; Coria Honoraria Speaking and teaching; Sanofi-Aventis Honoraria Speaking and teaching

David F Butler, MD  Professor of Dermatology, Texas A&M University College of Medicine; Chair, Department of Dermatology, Director, Dermatology Residency Training Program, Scott and White Clinic, Northside Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, American Medical Association, American Society for Dermatologic Surgery, American Society for MOHS Surgery, Association of Military Dermatologists, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Christen M Mowad, MD  Associate Professor, Department of Dermatology, Geisinger Medical Center

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Catherine M Quirk, MD  Clinical Assistant Professor, Department of Dermatology, University of Pennsylvania

Catherine M Quirk, MD is a member of the following medical societies: Alpha Omega Alpha and American Academy of Dermatology

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD  Director, Department of Dermatology, Geisinger Medical Center

Dirk M Elston, MD is a member of the following medical societies: American Academy of Dermatology

Disclosure: Nothing to disclose.

References

  1. Thalhammer C, Aschwanden M. [Mondor's disease]. Dtsch Med Wochenschr. Feb 16 2007;132(7):325-6. [Medline].

  2. Al-Mwalad M, Loertzer H, Wicht A, Fornara P. Subcutaneous penile vein thrombosis (Penile Mondor's Disease): pathogenesis, diagnosis, and therapy. Urology. Mar 2006;67(3):586-8. [Medline].

  3. Hogan GF. Mondor's disease. Arch Intern Med. Jun 1964;113:881-5. [Medline].

  4. Alvarez-Garrido H, Garrido-Rios AA, Sanz-Munoz C, Miranda-Romero A. Mondor's disease. Clin Exp Dermatol. Oct 2009;34(7):753-6. [Medline].

  5. Khan UD. Mondor disease: a case report and review of the literature. Aesthet Surg J. May-Jun 2009;29(3):209-12. [Medline].

  6. Quehe P, Saliou AH, Guias B, Bressollette L. [Mondor's disease, report on three cases and literature review]. J Mal Vasc. Feb 2009;34(1):54-60. [Medline].

  7. Weinstein EC. Mondor's disease. West J Med. Jul 1975;123(1):56-7. [Medline].

  8. Herrmann JB. Thrombophlebitis of breast and contiguous thoracicoabdominal wall (Mondor's disease). N Y State J Med. Dec 15 1966;66(24):3146-52. [Medline].

  9. Loos B, Horch RE. Mondor's disease after breast reduction surgery. Plast Reconstr Surg. Jun 2006;117(7):129e-132e. [Medline].

  10. Talhari C, Mang R, Megahed M, Ruzicka T, Stege H. Mondor disease associated with physical strain: report of 2 cases. Arch Dermatol. Jun 2005;141(6):800-1. [Medline].

  11. Oldfield MC. Mondor's disease. A superficial phlebitis of the breast. Lancet. May 12 1962;1:994-6. [Medline].

  12. Feller N. [Mondor's disease.]. Dapim Refuiim. Aug 1962;21:423-5. [Medline].

  13. Bauer-Hack K. [Contribution to Mondor's disease.]. Med Welt. Oct 13 1962;41:2152-6. [Medline].

  14. Losanoff JE, Basson MD, Salwen WA, Sochaki P. Mondor's disease mimicking a Spigelian hernia. Hernia. Jan 9 2008;[Medline].

  15. Kondo T. Traumatic funicular phlebitis of the thoracic wall resembling Mondor's disease: a case report. J Med Case Reports. Mar 30 2011;5(1):127. [Medline]. [Full Text].

  16. Dicuio M, Pomara G, Ales V, Fabris FM, Dahlstrand C, Morelli G. Doppler ultrasonography in a young patient with penile Mondor's disease. Arch Ital Urol Androl. Mar 2005;77(1):58-9. [Medline].

  17. Bircher J, Schirger A, Clagett OT, Harrison EG Jr. Mondor's disease: a vascular rarity. Mayo Clin Proc. Nov 21 1962;37:651-6. [Medline].

  18. Guerri G. [Histopathology and significance of cord formations on the anterolateral chest wall (Mondor's disease and syndrome).]. Arch De Vecchi Anat Patol. Oct 1960;33:829-57. [Medline].

 
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Illustration of the venous channels involved in Mondor disease. A is superior epigastric vein. B is thoracoepigastric vein. C is lateral thoracic vein.
 
 
 
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