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Objectives: The aim of this study is to review the clinical presentations, diagnostic methods, treatment options and outcome of patients with Granulomatous Mastitis (GM)., Material and Methods: In a retrospective study, we indentified 206 women who met the required histological criteria of (GM)., Results: Thirty eight (18%) of these women had taken antibiotics before their diagnosis of GM. The most common symptoms in remaining 168 symptomatic women were breast mass. The most common ultrasonographic and mammographic finding was large irregular hypo echoic masses and an irregular mass, respectively. As a diagnostic tool, fine needle aspiration (FNA) was performed in 33 (19.5%) and core needle biopsy with or without ultrasound was done in 92 (55%) of patients while successful rate was 13 (39%) and 87 (94.5%), respectively. The remaining 43 (25.5%) of women underwent surgical excisions. Only 6 (3%) patients improved with antibiotics and 200 (97%) of women who did not respond to antibiotics, were treated with steroid and among them 144 (72%) improved. Treatment with combination of methotrexate and steroid was done in 56 (28%) patients and was effective in 40 (71%) of them. Sixteen (8%) patients were treated with a combination of steroid and bromocriptine which was effective in 5 (31%) patients. A wide surgical excision was performed in 11 (5.5%) patients who were nonresponsive to steroid and methotrexate and bromocriptine therapy., Conclusion: Our findings indicate that clinical and imaging findings of (GM) have overlapped with malignancy. The best diagnostic method is core needle biopsy. Corticosteroids are in the first line of treatment with a good therapeutic response., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

Self-mutilation means direct and deliberate destruction of one's own body tissue without intending suicide. Some of the forensic referrals are the fraudulent persons who wish to obtain insurance benefits by simulating self-induced harms as injuries due to accidents. In this article we report five cases of self-mutilation for the purpose of obtaining insurance payments. These cases were interesting because of the following reasons: (1) Fracture of the tibia bone for the purpose of obtaining insurance payments is extremely rare. To our knowledge, the specialised literature does not present a similar case study as we described here. (2) In the cases we describe here, nobody had prior history of social and psychiatric problems and violence. In addition, on examination, no sign of previous scars was found in the whole body skin. (3) Self-mutilation injuries are often painless, parallel and delicate lines which are most frequently in the upper limb opposite to the dominant hand and in the areas that can be easily reached. In one of our cases, self-mutilation of the leg shin and the dominant hand were on the same side of the body. (4) In our study, all of the cases had high school education and were from small counties. Four patients were within the age range of 20-30 years, living in a populous family (six-member family) and of middle socioeconomic status. These results are consistent with previously available data for self-mutilation in Iran., (Copyright © 2013 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.)