1
|
Kaki M, Klein S, Singh C, Kothe B, Martin J. An Immunohistochemical Anomaly: A Case Report and Systematic Review of Myofibroblastoma of the Breast. Cureus 2023; 15:e46125. [PMID: 37900540 PMCID: PMC10612385 DOI: 10.7759/cureus.46125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 09/28/2023] [Indexed: 10/31/2023] Open
Abstract
Myofibroblastoma (MFB) is a rare but benign mesenchymal tumor most commonly appearing within breast tissue. Most cases of MFB occur in postmenopausal women and are treated by surgical excision. The diagnosis of MFB is made through immunohistochemical (IHC) analysis, with the most common biomarkers being CD34+, desmin+, smooth muscle actin+, and vimentin+. In this article, we describe a case of an MFB in a premenopausal female with variance from classic IHC findings. We also performed a systemic review of the MFB of the breast. The systemic review compiles the most common IHC findings of MFB, patient demographics, treatment methods, lesion size, and the presence or absence of pain associated with the lesion. As MFB can share many features with other breast lesions, including potentially malignant ones, this article sought to underline the most common IHC findings and characteristics of MFB to aid in the proper diagnosis of MFB.
Collapse
Affiliation(s)
- Mohamad Kaki
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Davie, USA
| | - Sarah Klein
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Clearwater, USA
| | - Chinar Singh
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Breanne Kothe
- Dr. Kiran C. Patel College of Osteopathic Medicine, Nova Southeastern University, Fort Lauderdale, USA
| | - Jose Martin
- General Surgery, Broward Health, Tamarac, USA
| |
Collapse
|
2
|
Yan M, Bomeisl P, Gilmore H, Sieck L, Kuchta Z, Harbhajanka A. Clinicopathological and radiological characterization of myofibroblastoma of breast: A single institutional case review. Ann Diagn Pathol 2020; 48:151591. [PMID: 32829069 DOI: 10.1016/j.anndiagpath.2020.151591] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 07/06/2020] [Indexed: 10/23/2022]
Abstract
Myofibroblastoma is a rare type of benign myofibroblastic neoplasm in the breast. It is clinically presented as a well-circumscribed mass, usually small in size (usually less than 4.0 cm), and can mostly be cured by local excision. Rare cases of giant myofibroblastoma greater than 10 cm have been reported, but also follow a benign clinical course. Histologically, breast myofibroblastoma is featured by bland fascicles of spindle cells intermixed with thick hyalinized collagen bundles. Mast cells are frequently found within the stroma. However, a wide spectrum of morphological variants can occur in myofibroblatoma, making its diagnosis challenging sometimes. Differential diagnosis of myofibroblastoma with other spindle cell lesions in the breast, either benign or malignant, is also important in practice. In this study, we collected 15 cases of breast myofibroblastoma diagnosed in our institution during a 20 year period. The sizes of these cases range from 0.4 cm to 35.2 cm (mean is 3.7 cm). To our knowledge, the case of giant breast myofibroblastoma we presented here is the largest one reported to date. The histological examination of the cases show great morphological variations. Besides the classical type, features of cellular, collagenized, palisading, epithelioid, myxoid, myoid, solitary fibrous tumor-like are also identified in the case series. Immunohistochemical staining patterns as well as clinical features of the cases are also summarized and compared. All cases in this study show no recurrence on follow-up. In addition, cases that are important differential diagnosis for breast myofibroblastoma are also studied. Their key histological characteristics are compared with myofibroblastoma, and their immunohistochemical and molecular features are discussed.
Collapse
Affiliation(s)
- Mingfei Yan
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University, Cleveland, OH, USA.
| | - Phillip Bomeisl
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University, Cleveland, OH, USA
| | - Hannah Gilmore
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University, Cleveland, OH, USA
| | - Leah Sieck
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University, Cleveland, OH, USA
| | - Zachariah Kuchta
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Aparna Harbhajanka
- Department of Pathology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA; Case Western Reserve University, Cleveland, OH, USA
| |
Collapse
|
3
|
Elhadi M, Younis A, Harding C. A systematic approach to the investigation and treatment of nocturia. JOURNAL OF CLINICAL UROLOGY 2020. [DOI: 10.1177/2051415818781289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Level of evidence: 4.
Collapse
|