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Yamazaki H, Koizumi K, Watahiki M, Takatsuka D, Asano Y, Goto M, Shiiya N, Baba S. Neurofibroma with adenosis in the mammary gland: a case report. Surg Case Rep 2023; 9:90. [PMID: 37246203 DOI: 10.1186/s40792-023-01673-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 05/17/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Neurofibroma of the breast is extremely rare, with only a few reported cases. Here, we report a case of solitary neurofibroma of the breast in a 95-year-old woman. CASE PRESENTATION A 95-year-old woman presented with a palpable mass in the left breast. Mammography revealed a well-defined mass. A 1.6-cm round mass was found in the lower outer quadrant of the left breast on ultrasonography. The internal echo of the tumor was a mixture of relatively uniform hypoechoic areas with posterior enhancement and heterogeneous hyperechoic areas. She underwent a core needle biopsy. The pathological findings revealed a spindle cell lesion with no malignant findings. At 2 months follow-up, repeat breast ultrasonography showed that the mass had enlarged to be 2.7 cm in size. A repeat core needle biopsy, however, revealed no particularly new information. Because the tumor was growing and a definite diagnosis was not made, lumpectomy was performed. We found bland-spindled cells with shredded-carrot collagen bundles. Immunohistochemical antibody markers (S100, SOX10, and CD34) were positive for the spindle cells. Some of the tumors maintained the bilayer nature of luminal cells and myoepithelial cells, which might be the reason for internal heterogeneity on ultrasound. A histological diagnosis of neurofibroma with adenosis was made. At 6 months follow-up, no recurrent lesions were found. CONCLUSIONS Ultrasound and pathological images revealed an extremely rare case of neurofibroma combined with adenosis. Tumor resection was performed because it was difficult to make a definitive diagnosis using needle biopsy. Even when a benign tumor is suspected, short-term follow-up is necessary, and if an enlargement is observed, early tumor resection is recommended.
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Affiliation(s)
- Hirokazu Yamazaki
- First Department of Surgery, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Higashi‑ku, Hamamatsu, Shizuoka, 431‑3192, Japan.
| | - Kei Koizumi
- First Department of Surgery, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Higashi‑ku, Hamamatsu, Shizuoka, 431‑3192, Japan
| | - Mana Watahiki
- First Department of Surgery, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Higashi‑ku, Hamamatsu, Shizuoka, 431‑3192, Japan
| | - Daiki Takatsuka
- First Department of Surgery, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Higashi‑ku, Hamamatsu, Shizuoka, 431‑3192, Japan
| | - Yuko Asano
- First Department of Surgery, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Higashi‑ku, Hamamatsu, Shizuoka, 431‑3192, Japan
| | - Mana Goto
- Department of Pathology, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Higashi‑ku, Hamamatsu, Shizuoka, 431‑3192, Japan
| | - Norihiko Shiiya
- First Department of Surgery, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Higashi‑ku, Hamamatsu, Shizuoka, 431‑3192, Japan
| | - Satoshi Baba
- Department of Pathology, Hamamatsu University School of Medicine, 1‑20‑1 Handayama, Higashi‑ku, Hamamatsu, Shizuoka, 431‑3192, Japan
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2
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Tahir M, Zedan M, Bellamkonda V, Dyess DL, Wei EX. Primary Malignant Peripheral Nerve Sheath Tumor of the Breast: A Rare Case Report and Review of Literature. Cureus 2022; 14:e31586. [DOI: 10.7759/cureus.31586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2022] [Indexed: 11/17/2022] Open
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3
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Locklin J, Bhatt AA. Incidental Breast Mass in a Male Patient. JOURNAL OF BREAST IMAGING 2021; 3:740-741. [PMID: 38424926 DOI: 10.1093/jbi/wbab019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Indexed: 03/02/2024]
Affiliation(s)
- Jasmine Locklin
- Mayo Clinic, Department of Breast Imaging and Intervention, Rochester, MN, USA
| | - Asha A Bhatt
- Mayo Clinic, Department of Breast Imaging and Intervention, Rochester, MN, USA
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4
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Caputo A, Addesso M, D'Antonio A. Nervous Nipple: Pseudopolythelia Caused by a Neurofibroma of the Areola. Am J Dermatopathol 2021; 43:e111-e112. [PMID: 33577179 DOI: 10.1097/dad.0000000000001916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT The presence of a supernumerary nipple inside the original areola is a rare condition termed intra-areolar polythelia. Rarely, a lesion can macroscopically resemble a nipple. We report a case of a solitary neurofibroma (by itself rare in the areola) mimicking a second, twin nipple. In this case, these 2 rare conditions merge resulting in pseudopolythelia. The relevant literature on polythelia and neurofibromas of the breast is briefly reviewed.
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Affiliation(s)
- Alessandro Caputo
- University of Salerno, Department of Medicine and Surgery, Salerno, Italy
| | - Maria Addesso
- Hospital Tortora, Department of Pathology, Pagani (SA), Italy ; and
| | - Antonio D'Antonio
- University of Salerno, Department of Medicine and Surgery, Salerno, Italy
- Department of Pathology, University Hospital "San Giovanni di Dio e Ruggi D'Aragona", Salerno, Italy
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Yin C, Porembka JH, Hwang H, Hayes JC. Neurofibroma in the Breast: Diagnosis and Management Considerations. JOURNAL OF BREAST IMAGING 2021; 3:363-368. [PMID: 38424772 DOI: 10.1093/jbi/wbab008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Indexed: 03/02/2024]
Abstract
Neurofibroma (NF) of the breast is an uncommon benign entity that occurs sporadically or in association with neurofibromatosis type 1 (NF1). Sporadic NF of the breast is very rare and can present at any age. Neurofibroma of the breast associated with NF1 is more common. Neurofibroma commonly presents as oval, circumscribed masses that overlap with many benign entities. The histopathologic diagnosis of NF of the breast can present a management dilemma for the breast radiologist. An NF that is not associated with NF1 has good post-resection prognosis if superficial, sporadic, and solitary. However, NF of the breast diagnosed in an otherwise healthy patient should prompt evaluation for NF1 and formal genetic risk assessment. Patients diagnosed with NF1 have a higher lifetime risk for developing breast cancer and therefore may benefit from both initiating screening mammography at a younger age and supplemental screening MRI.
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Affiliation(s)
- Chen Yin
- University of Texas Southwestern Medical Center, Department of Radiology; Dallas, TX, USA
| | - Jessica H Porembka
- University of Texas Southwestern Medical Center, Department of Radiology; Dallas, TX, USA
| | - Helena Hwang
- University of Texas Southwestern Medical Center, Department of Pathology, Dallas, TX, USA
| | - Jody C Hayes
- University of Texas Southwestern Medical Center, Department of Radiology; Dallas, TX, USA
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da Costa Vieira RA, de Araujo Silva I, de Souza Coelho RD, de Almeida Junior CR, de Almeida Santos Yamashita ME. Brachial plexus schwannoma mimicking advanced breast carcinoma. Breast Dis 2021; 39:109-113. [PMID: 32083563 DOI: 10.3233/bd-190432] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Schwannoma is an extremely rare benign tumour of the peripheral nervous system; its association with breast cancer is sporadic, and its association with the brachial plexus is extremely rare. CASE DESCRIPTION The authors report a case of a patient with breast cancer associated with nodulation in the left supraclavicular fossa, and due to the clinical and radiological features, it was considered metastatic lymph node disease. The patient underwent neoadjuvant chemotherapy, with partial response of the breast. Surgical treatment included resection of the supraclavicular nodule, which was found to be a supraclavicular fossa schwannoma. The correct diagnosis, influences the radiotherapeutic planning. The unusual presentation led to diagnostic confusion in the present case, a fact that changed the breast treatment. CONCLUSION The best of our knowledge it is the third description of brachial plexus schwannoma associated with breast cancer and the first with a synchronous association. The knowledge of this pathology and its potential to alter treatment justify the reporting of the present case.
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Affiliation(s)
| | - Igor de Araujo Silva
- Departamento de Mastologia e Reconstrução Mamária, Hospital de Câncer de Barretos, São Paulo, Brazil
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Magro G, Salvatorelli L, Puzzo L, Piombino E, Bartoloni G, Broggi G, Vecchio GM. Practical approach to diagnosis of bland-looking spindle cell lesions of the breast. Pathologica 2020; 111:344-360. [PMID: 31965112 PMCID: PMC8145669 DOI: 10.32074/1591-951x-31-19] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 10/28/2019] [Indexed: 12/22/2022] Open
Abstract
The diagnosis of bland-looking spindle cell lesions of the breast is often challenging because there is a close morphological and immunohistochemical overlap among the different entities. The present review will discuss reactive spindle cell nodule/exuberant scar, nodular fasciitis, inflammatory pseudotumor, myofibroblastoma (classic type), lipomatous myofibroblastoma, palisaded myofibroblastoma, benign fibroblastic spindle cell tumor, spindle cell lipoma, fibroma, leiomyoma, solitary fibrous tumor, myxoma, schwannoma/neurofibroma, desmoid-type fibromatosis, dermatofibrosarcoma protuberans, low-grade fibromatosis-like spindle cell carcinoma, inflammatory myofibroblastic tumor and low-grade myofibroblastic sarcoma arising in the breast parenchyma. The pathologist should be aware of each single lesion to achieve a correct diagnosis to ensure patient a correct prognostic information and therapy. Accordingly representative illustrations and morphological/immunohistochemical diagnostic clues will be provided.
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Affiliation(s)
- G Magro
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
| | - L Salvatorelli
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
| | - L Puzzo
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
| | - E Piombino
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
| | - G Bartoloni
- Anatomic Pathology, A.R.N.A.S. Garibaldi-Nesima, Catania, Italy
| | - G Broggi
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
| | - G M Vecchio
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Azienda Ospedaliero-Universitaria "Policlinico Vittorio Emanuele", Anatomic Pathology, School of Medicine, University of Catania, Italy
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8
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Khattab RA, Rowe JJ, Booth CN, Sneige N, Fong N, Pantanowitz L, Oshilaja O, Brainard JA, Downs-Kelly EP, Dawson A, Sturgis CD. Mammary mesenchymal and fibroepithelial lesions: An illustrated cytomorphologic update with differential diagnoses. Diagn Cytopathol 2019; 47:1100-1118. [PMID: 31343114 DOI: 10.1002/dc.24288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Revised: 07/08/2019] [Accepted: 07/15/2019] [Indexed: 11/06/2022]
Abstract
The Uniform Approach to Breast Fine Needle Aspiration Biopsy was put forward by a learned group of breast physicians in 1997. This landmark manuscript focused predominantly on diagnosis and reporting of mammary epithelial lesions. Today, most American practitioners turn initially to core biopsy rather than aspiration biopsy for the first line diagnosis of solid breast lesions; however, recent efforts from the International Academy of Cytology have produced a system called the Standardized Reporting of Breast Fine Needle Aspiration Biopsy Cytology (colloquially labeled in 2017 as the "Yokohama System"), suggesting a new interest in breast fine needle aspiration (FNA), especially in resource limited settings or clinical practice settings with experienced breast cytopathologists. Fibroepithelial lesions of the breast comprise a heterogeneous group of biphasic tumors with epithelial and stromal elements. Mesenchymal lesions of the breast include a variety of neoplasms of fibroblastic, myofibroblastic, endothelial, neural, adipocytic, muscular, and osteo-cartilaginous derivations. The cytology of mesenchymal breast lesions is infrequently described in the literature and is mainly limited to case reports and small series. This illustrated review highlights the cytologic features of fibroepithelial and mesenchymal mammary proliferations and discusses differential diagnoses and histomorphologic correlates.
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Affiliation(s)
- Ruba A Khattab
- Department of Pathology, University Hospitals of Case Western Reserve University, Cleveland, Ohio
| | - J Jordi Rowe
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio
| | | | - Nour Sneige
- Department of Pathology, Houston Methodist Hospital, Weill Cornell Medical College, Houston, Texas
| | - Nancy Fong
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio
| | - Liron Pantanowitz
- Department of Pathology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | | | | | - Andrea Dawson
- Department of Pathology, Cleveland Clinic, Cleveland, Ohio
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Abstract
Spindle cell lesions of the breast cover a wide spectrum of diseases ranging from reactive tumor-like lesions to high-grade malignant tumors. The recognition of the benign spindle cell tumor-like lesions (nodular fasciitis; reactive spindle cell nodule after biopsy, inflammatory pseudotumor/inflammatory myofibroblastic tumor; fascicular variant of pseudoangiomatous stromal hyperplasia) and tumors (myofibroblastoma, benign fibroblastic spindle cell tumor, leiomyoma, schwannoma, spindle cell lipoma, solitary fibrous tumor, myxoma) is crucial to avoid confusion with morphologically similar but more aggressive bland-appearing spindle cell tumors, such as desmoid-type fibromatosis, low-grade (fibromatosis-like) spindle cell carcinoma, low-grade fibrosarcoma/myofibroblastic sarcoma and dermatofibrosarcoma protuberans.
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Affiliation(s)
- Gaetano Magro
- Department of Medical and Surgical Sciences and Advanced Technologies, G.F. Ingrassia, Anatomic Pathology, University of Catania, Via S. Sofia 87, Catania 95123, Italy.
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10
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Rotili A, De Maria F, Di Venosa B, Ghioni M, Pizzamiglio M, Cassano E, Moratti M. Solitary breast neurofibroma: imaging aspects. Ecancermedicalscience 2018; 12:800. [PMID: 29456617 PMCID: PMC5813918 DOI: 10.3332/ecancer.2018.800] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Indexed: 11/17/2022] Open
Abstract
Neurofibromas are benign peripheral nerve sheath tumours, which are usually solitary and sporadic. Solitary neurofibromas of the breast are rare. The most common location of a breast neurofibroma is the nipple–areola complex. We report a rare case of a 56-year-old woman with a solitary neurofibroma of the right breast sulcus.
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Affiliation(s)
- Anna Rotili
- Division of Breast Radiology, European Institute of Oncology, Milan 20137, Italy
| | - Federica De Maria
- Division of Breast Radiology, European Institute of Oncology, Milan 20137, Italy
| | | | | | - Maria Pizzamiglio
- Division of Breast Radiology, European Institute of Oncology, Milan 20137, Italy
| | - Enrico Cassano
- Division of Breast Radiology, European Institute of Oncology, Milan 20137, Italy
| | - Michela Moratti
- Division of Breast Radiology, European Institute of Oncology, Milan 20137, Italy.,Ospedale Santa Maria delle Croci, Centro di Prevenzione Oncologica, Viale Randi 5, Ravenna 48121, Italy
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11
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Cheng E, Viswanathan K, Hoda S. Solitary Neurofibroma of the Breast, and “The Man From Istanbul” Syndrome. Int J Surg Pathol 2017; 26:153-154. [DOI: 10.1177/1066896917728337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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