eMedicine Specialties > Dermatology > Diseases of the Vessels

Mondor Disease

Author: Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-New Jersey Medical School
Coauthor(s): Matthew J Trovato, MD, Staff Physician, Department of Dermatology, UMDNJ-New Jersey Medical School
Contributor Information and Disclosures

Updated: Apr 30, 2008

Introduction

Background

First described in detail by Henri Mondor in 1939, this condition is a rare entity characterized by a sclerosing thrombophlebitis of the subcutaneous veins of the anterior chest wall. The sudden appearance of a subcutaneous cord, which is initially red and tender and subsequently becomes a painless, tough, fibrous band that is accompanied by tension and skin retraction, is characteristic. The condition, though benign and self-limited, has been associated with breast cancer. It requires only symptomatic therapy. However, the physician must be aware of its existence to properly diagnose it and to rule out the presence of systemic disorders, especially breast cancer.1

Subcutaneous penile vein thrombosis (penile Mondor disease) has also been described.2 Its pathogenesis is unknown. It appears suddenly as almost painless indurations on the penile dorsal surface.

A related eMedicine article is Superficial Thrombophlebitis.

Pathophysiology

The pathophysiology has been explained as pressure on the vein with stagnation of blood or as direct trauma to the vein itself. In cases that do not show such evidence, the most reasonable explanation is on the basis of repeated movement of the breast along with the contracting and relaxing pectoral muscles, which causes stretching and relaxing of the veins.3

Mondor disease may only involve 1 or more of 3 venous channels: the thoracoepigastric vein, the lateral thoracic vein, and the superior epigastric vein. The upper, inner portions of the breast are never involved.

Race

No racial or ethnic predilection is evident.

Sex

Mondor disease is 3 times more common in women than in men.4

Age

The disease can occur in persons of any age, but most patients are aged 30-60 years.4

Clinical

History

  • 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.5 Mondor disease may occur after breast reduction surgery.6
    • Possibly, physical strain7
    • Tight dressings and tight-fitting bras8
    • Axillary shaving9
    • Blood dyscrasia10
  • 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.

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

Causes

See Pathophysiology.

More on Mondor Disease

Overview: Mondor Disease
Differential Diagnoses & Workup: Mondor Disease
Treatment & Medication: Mondor Disease
Follow-up: Mondor Disease
Multimedia: Mondor Disease
References
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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. Weinstein EC. Mondor's disease. West J Med. Jul 1975;123(1):56-7. [Medline].

  5. 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].

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

  7. 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].

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

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

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

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

  12. 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].

  13. 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].

  14. 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].

  15. Holle-Robatsch S, Fink AM, Schubert C, Steiner A, Partsch H. [Mondor phlebitis associated with hepatitis C]. Vasa. Nov 2001;30(4):297-8. [Medline].

  16. Luis Rodríguez-Peralto J, Carrillo R, Rosales B, Rodríguez-Gil Y. Superficial thrombophlebitis. Semin Cutan Med Surg. Jun 2007;26(2):71-6. [Medline].

  17. Mayor M, Buron I, de Mora JC, Lazaro TE, Hernandez-Cano N, Rubio FA, et al. Mondor's disease. Int J Dermatol. Dec 2000;39(12):922-5. [Medline].

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Further Reading

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Keywords

Mondor's disease, Mondor phlebitis, superficial thrombophlebitis of the chest wall

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Contributor Information and Disclosures

Author

Robert A Schwartz, MD, MPH, Professor and Head of Dermatology, Professor of Medicine, Professor of Pediatrics, Professor of Pathology, Professor of Preventive Medicine and Community Health, UMDNJ-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, Staff Physician, Department of Dermatology, UMDNJ-New Jersey Medical School
Matthew J Trovato, MD is a member of the following medical societies: Alpha Omega Alpha
Disclosure: Nothing to disclose.

Medical Editor

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: Nothing to disclose.

Pharmacy Editor

David F Butler, MD, Professor of Dermatology, Texas A&M University College of Medicine; Director, Division of Dermatology, Scott and White Clinic; Director Dermatology Residency Training Program, Scott and White 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: 3M Pharmaceutical Grant/research funds Other; Graceway Pharmaceuticals Grant/research funds Other

Managing Editor

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.

CME Editor

Catherine Quirk, MD, Clinical Assistant Professor, Department of Dermatology, Brown University
Catherine 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.

 
 
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