Occult medullary breast carcinoma in a male

Occult breast cancer (OBC) or breast cancer presenting without an evident primary tumor is a rare presentation and can lead to a diagnostic dilemma. Further, the treatment of OBC is a subject of much controversy. We present a 47-year-old male who had been admitted with a fungating lesion in his axilla. As clinical examination was unremarkable, a punch biopsy from the lesion revealed a medullary carcinoma of breast. The purpose of this report is to highlight this unusual presentation of carcinoma breast and the treatment dilemma that it poses, especially in men, where breast cancer is seldom considered a diagnostic possibility in the setting of occult primary cancer. This is the first-ever case report of medullary carcinoma presenting as OBC in a male.