Mondor’s disease is characterized by inflammation and clotting in a superficial vein, a process known as superficial thrombophlebitis. This rare disorder was first described by the French surgeon Henri Mondor in 1939. The condition primarily affects veins beneath the skin, causing a distinctive physical symptom. Despite its alarming presentation, Mondor’s disease is considered a self-limiting condition that typically resolves without long-term consequences.
What is Mondor’s Disease?
Mondor’s disease is a form of superficial thrombophlebitis where a blood clot forms in a vein near the body’s surface, leading to an inflammatory response. The vein becomes occluded, and the surrounding tissue reacts, resulting in a hardening and thickening of the vessel wall. This process is localized and does not usually involve the deeper veins of the body.
The primary physical sign is the sudden appearance of a palpable, tender, cord-like structure just under the skin. This fibrous cord is accompanied by localized pain and tenderness, which may worsen with movement or when the skin is stretched. The overlying skin may show mild redness, or in the case of the breast, appear slightly pulled in or retracted. The condition is considered benign and typically resolves itself.
Prevalence and Anatomical Variations
Mondor’s disease is an extremely rare clinical entity, likely underreported due to its self-limiting nature. Patients often do not seek medical attention because symptoms are minimal or the condition resolves before diagnosis. When evaluated in dedicated breast clinics, the incidence of chest wall Mondor’s disease is reported to be in the range of 0.08% to 0.94%.
The rarity of the condition varies significantly depending on the anatomical site involved. The most commonly reported form affects the anterolateral chest wall and breast, involving veins like the thoracoepigastric or superior epigastric veins. This variant occurs far more frequently in women, typically aged 30 to 60, with a female-to-male ratio as high as 9-to-1.
A less common presentation is penile Mondor’s disease, involving the superficial dorsal vein of the penis. This form accounts for less than 10% of all cases and is most often seen in men between 20 and 40 years old. The condition can also manifest in the armpit (axillary web syndrome), or more rarely in the groin and abdomen. These anatomical variations make a single overall prevalence figure for the general population difficult to ascertain.
Understanding the Underlying Causes
The precise cause of Mondor’s disease is often not identified, which is why 45% to 60% of cases are classified as idiopathic. The condition results from factors that contribute to clot formation in the superficial vein, following Virchow’s triad: vessel wall damage, blood flow stagnation, and hypercoagulation. Trauma or injury is a frequently cited trigger, accounting for approximately 22% of reported cases.
Trauma can be direct, such as a blunt impact, or repetitive stress from activities like intense exercise, especially in bodybuilders, or wearing restrictive clothing like a tight brassiere. Surgical or invasive procedures are also known predisposing factors, contributing to about 20% of cases. Examples include breast surgery, core needle biopsies, or axillary lymph node dissection. Other less common associations include recent infections, underlying hypercoagulable states, or dehydration.
Treatment and Recovery Expectations
The diagnosis of Mondor’s disease is primarily clinical; a healthcare provider can usually confirm the condition based on physical examination and the characteristic cord-like finding. Imaging, such as a Doppler ultrasound, may be used to confirm a superficial clot and rule out other conditions, but it is not always necessary. Because it is a benign and self-limiting condition, the standard management approach is conservative and supportive.
Treatment focuses on symptom relief, most often through non-steroidal anti-inflammatory drugs (NSAIDs) to manage pain and inflammation. Applying local heat or warm compresses can also help alleviate discomfort. Patients are advised to modify their activity and avoid anything that aggravates the condition, such as sexual activity in the case of penile involvement or wearing tight clothing. The prognosis is excellent, with the fibrous cord typically resolving completely within four to eight weeks, though some cases may take up to six months.