Presenting a case of male breast cancer among male Saudi population and reviewing related literature, we aim to highlight the importance of increased awareness towards the existence of such disease among the Saudi population, and to observe any differences in clinical manifestation from those reported in literature.

Case Report
A seventy eight year old Saudi male presented to our outpatient clinic with left breast pain of two month's duration. Examination revealed a 2 x 1 cm hard medial sub-areola tender mass with irregular borders almost fixed to underlying structure. This was associated with mild left nipple retraction and a 1 x 1 cm non-tender left axillary node. The mammography report noted: 'A 1.5 cm stellate mass of left breast consistent with carcinoma. Two small lymph nodes present at left upper outer quadrant, one dense in craniocaudal view and may be involved with metastasis.' Carcino-embryonic antigen (CEA), liver function tests, calcium, prostatic specific antigen, right upper quadrant ultrasound and chest x-ray were reported as normal. A fine needle aspiration revealed findings consistent with invasive carcinoma. The patient underwent modified left radical mastectomy with right axillary sampling.

Histopathological examination of the tumor revealed infiltrating ductal carcinoma, moderately differentiated (Grade 2 according to Modified Scarff- Bloom-Richardson grading system). There were cords and nests of malignant epithelial cells embedded within dense collagenous stroma; some are surrounding normal non-neoplastic ducts (Figure 1). In addition, there were foci of intraductal comedo carcinoma featuring dilated ducts lined by malignant epithelial cells with central necrosis (Figure 2).