History

Mondor disease is most often observed as a cordlike indurated plaque on the upper anterolateral aspect of the chest wall.^{[18, 20]}No systemic symptoms are usually present, although rarely there may be chest pain.^[21]

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.^[22]Mondor disease may occur after breast reduction surgery.^[23]
Possible physical strain,^[24]as might be experienced by bodybuilders^[8]
Tight dressings and tight-fitting bras^[25]
Axillary shaving^[26]
Blood dyscrasia^[27]

Subcutaneous penile vein thrombosis of other sites has also been described.^[2]It is first evident as sudden and almost painless indurations on the penile dorsal surface.^[28]In the axillae, it may occur after axillary lymph node dissection and sentinel lymph node biopsy.^[5]

Physical Examination

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. It may also be evident as retracted breast skin.^[29]

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.^[6]

Complications

Mondor phlebitis is not migratory and does not recur.

Differential Diagnoses

Thalhammer C, Aschwanden M. [Mondor's disease]. Dtsch Med Wochenschr. 2007 Feb 16. 132(7):325-6. [QxMD MEDLINE Link].
Al-Mwalad M, Loertzer H, Wicht A, Fornara P. Subcutaneous penile vein thrombosis (Penile Mondor's Disease): pathogenesis, diagnosis, and therapy. Urology. 2006 Mar. 67(3):586-8. [QxMD MEDLINE Link].
Kostrzewa O, Kołodziej P, Majdan M, Zwolak R, Górak A, Bar K. [Mondor's disease or systemic sclerosis - diagnostic and therapeutic dilemmas]. Wiad Lek. 2018. 71 (1 pt 1):93-95. [QxMD MEDLINE Link].
Hashimoto T, Satoh T. Atypical penile Mondor's disease occurring on the ventral aspect of the penis. J Dermatol. 2020 Feb. 47 (2):e58-e60. [QxMD MEDLINE Link].
Shoham Y, Rosenberg N, Krieger Y, Silberstein E, Arnon O, Bogdanov-Berezovsky A. [Axillary web syndrome--a variant of Mondor's disease, following excision of an accessory breast]. Harefuah. 2011 Dec. 150(12):893-4, 937, 936. [QxMD MEDLINE Link].
Hogan GF. Mondor's disease. Arch Intern Med. 1964 Jun. 113:881-5. [QxMD MEDLINE Link].
Vincenza Polito M, De Cicco P, Apicella R. Tight Bra in a 34-Year-Old Woman: An Unusual Cause of Mondor's Disease. Ann Vasc Dis. 2014. 7(2):149-51. [QxMD MEDLINE Link]. [Full Text].
Tröbinger C, Wiedermann CJ. Bodybuilding-induced Mondor's disease of the chest wall. Phys Ther Sport. 2017 Jan. 23:133-135. [QxMD MEDLINE Link].
Alvarez-Garrido H, Garrido-Rios AA, Sanz-Munoz C, Miranda-Romero A. Mondor's disease. Clin Exp Dermatol. 2009 Oct. 34(7):753-6. [QxMD MEDLINE Link].
Marsaudon E, Legal C, Gayoux D, Weber O. [Mondor's disease of penis: A case report]. Rev Med Interne. 2016 Mar 10. [QxMD MEDLINE Link].
Obradovic K, Adzic N, Pavlovic Stankovic D, Petkovic I, Urban V, Milosevic Z. Superficial Thrombophlebitis of the Breast (Mondor's Disease): An Uncommon Localization of Common Disease. Clin Med Insights Case Rep. 2020. 13:1179547620972414. [QxMD MEDLINE Link].
Pignatti M, Loschi P, Pedrazzi P, Marietta M. Mondor's disease after implant-based breast reconstruction. Report of three cases and review of the literature. J Plast Reconstr Aesthet Surg. 2014 Jun 4. [QxMD MEDLINE Link].
Khan UD. Mondor disease: a case report and review of the literature. Aesthet Surg J. 2009 May-Jun. 29(3):209-12. [QxMD MEDLINE Link].
Salemis NS, Vasilara G, Lagoudianakis E. Mondor's disease of the breast as a complication of ultrasound-guided core needle biopsy: Management and review of the literature. Breast Dis. 2014 Jul 2. [QxMD MEDLINE Link].
Yordanov YP. Trauma on a Recently Augmented Breast as a Trigger for Mondor's Disease. Aesthetic Plast Surg. 2019 Feb 19. [QxMD MEDLINE Link].
Akan S, Ediz C. Isolated Superficial Dorsal Penile Vein Thrombosis due to Scabies Infestation. J Coll Physicians Surg Pak. 2020 Feb. 30 (2):216-218. [QxMD MEDLINE Link].
Sheikh MM, Jeelani HM, Farooqi A, Riaz A. Penile Mondor's Disease: Rare Association With Excessive Masturbation. Cureus. 2020 May 27. 12 (5):e8317. [QxMD MEDLINE Link].
Quehe P, Saliou AH, Guias B, Bressollette L. [Mondor's disease, report on three cases and literature review]. J Mal Vasc. 2009 Feb. 34(1):54-60. [QxMD MEDLINE Link].
Weinstein EC. Mondor's disease. West J Med. 1975 Jul. 123(1):56-7. [QxMD MEDLINE Link].
Stephan F, Maatouk I, Moutran R, Wehbe J, Obeid G. A case of idiopathic Mondor disease. Dermatol Online J. 2012 Jan 15. 18(1):14. [QxMD MEDLINE Link].
Suganthan N, Ratnasamy V. Mondor's disease - a rare cause of chest pain: a case report. J Med Case Rep. 2018 Jan 9. 12 (1):4. [QxMD MEDLINE Link].
Herrmann JB. Thrombophlebitis of breast and contiguous thoracicoabdominal wall (Mondor's disease). N Y State J Med. 1966 Dec 15. 66(24):3146-52. [QxMD MEDLINE Link].
Loos B, Horch RE. Mondor's disease after breast reduction surgery. Plast Reconstr Surg. 2006 Jun. 117(7):129e-132e. [QxMD MEDLINE Link].
Talhari C, Mang R, Megahed M, Ruzicka T, Stege H. Mondor disease associated with physical strain: report of 2 cases. Arch Dermatol. 2005 Jun. 141(6):800-1. [QxMD MEDLINE Link].
Oldfield MC. Mondor's disease. A superficial phlebitis of the breast. Lancet. 1962 May 12. 1:994-6. [QxMD MEDLINE Link].
Feller N. [Mondor's disease.]. Dapim Refuiim. 1962 Aug. 21:423-5. [QxMD MEDLINE Link].
Bauer-Hack K. [Contribution to Mondor's disease.]. Med Welt. 1962 Oct 13. 41:2152-6. [QxMD MEDLINE Link].
Manimala NJ, Parker J. Evaluation and Treatment of Penile Thrombophlebitis (Mondor's Disease). Curr Urol Rep. 2015 Jun. 16 (6):39. [QxMD MEDLINE Link].
Kadioglu H, Yildiz S, Ersoy YE, Yücel S, Müslümanoglu M. An unusual case caused by a common reason: Mondor's disease by oral contraceptives. Int J Surg Case Rep. 2013 Aug 3. 4(10):855-857. [QxMD MEDLINE Link].
Losanoff JE, Basson MD, Salwen WA, Sochaki P. Mondor's disease mimicking a Spigelian hernia. Hernia. 2008 Jan 9. [QxMD MEDLINE Link].
Kondo T. Traumatic funicular phlebitis of the thoracic wall resembling Mondor's disease: a case report. J Med Case Reports. 2011 Mar 30. 5(1):127. [QxMD MEDLINE Link]. [Full Text].
Schuppisser M, Khallouf J, Abbassi Z, Erne M, Vettorel D, Paroz A, et al. Abdominal Mondor disease mimicking acute appendicitis. Int J Surg Case Rep. 2016. 20:37-40. [QxMD MEDLINE Link].
Papeš D, Altarac S, Antabak A, Savić I. Nonvenereal Sclerosing Lymphangitis of the Penis. Acta Dermatovenerol Croat. 2015 Jul. 23 (2):1501-151. [QxMD MEDLINE Link].
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. 2005 Mar. 77(1):58-9. [QxMD MEDLINE Link].
Bircher J, Schirger A, Clagett OT, Harrison EG Jr. Mondor's disease: a vascular rarity. Mayo Clin Proc. 1962 Nov 21. 37:651-6. [QxMD MEDLINE Link].
Ito H, Ishibashi S, Kaburagi T. Mondor's Disease. Intern Med. 2019 Feb 25. [QxMD MEDLINE Link].
Guerri G. [Histopathology and significance of cord formations on the anterolateral chest wall (Mondor's disease and syndrome).]. Arch De Vecchi Anat Patol. 1960 Oct. 33:829-57. [QxMD MEDLINE Link].
Pasta V, D'Orazi V, Sottile D, Del Vecchio L, Panunzi A, Urciuoli P. Breast Mondor's disease: Diagnosis and management of six new cases of this underestimated pathology. Phlebology. 2014 Sep 26. [QxMD MEDLINE Link].
Shirah BH, Shirah HA, Alonazie WS. The Effectiveness of Diclofenac Sodium in the Treatment of Mondor's Disease of the Breast: The Topical Patch Compared to the Oral Capsules. Breast J. 2017 Jan 12. [QxMD MEDLINE Link].

Media Gallery

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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Author

Robert A Schwartz, MD, MPH Professor and Head of Dermatology, Professor of Pathology, Professor of Pediatrics, Professor of Medicine, Rutgers New Jersey Medical School

Robert A Schwartz, MD, MPH is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, New York Academy of Medicine, Royal College of Physicians of Edinburgh, Sigma Xi, The Scientific Research Honor Society

Disclosure: Nothing to disclose.

Specialty Editor Board

David F Butler, MD Former Section Chief of Dermatology, Central Texas Veterans Healthcare System; Professor of Dermatology, Texas A&M University College of Medicine; Founding Chair, Department of Dermatology, Scott and White Clinic

David F Butler, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Dermatology, Association of Military Dermatologists, Phi Beta Kappa, Texas Dermatological Society

Disclosure: Nothing to disclose.

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

Christen M Mowad, MD is a member of the following medical societies: Alpha Omega Alpha, Noah Worcester Dermatological Society, Pennsylvania Academy of Dermatology, American Academy of Dermatology, Phi Beta Kappa

Disclosure: Nothing to disclose.

Chief Editor

Dirk M Elston, MD Professor and Chairman, Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina College of Medicine

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

Disclosure: Nothing to disclose.

Additional Contributors

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: Received honoraria from Stiefel for speaking and teaching; Received honoraria from Allergan for speaking and teaching; Received honoraria from Intendis for speaking and teaching; Received honoraria from Coria for speaking and teaching; Received honoraria from Sanofi-Aventis for speaking and teaching.

Acknowledgements

Matthew J Trovato, MD Fellow, Division of Plastic Surgery, Rutgers New Jersey Medical School

Disclosure: Nothing to disclose.