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Jung HK, Son JH, Kim WG. Myofibroblastoma of the breast in postmenopausal women: Two case reports with imaging findings and review of the literature. JOURNAL OF CLINICAL ULTRASOUND : JCU 2020; 48:279-282. [PMID: 32030771 DOI: 10.1002/jcu.22818] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 12/14/2019] [Accepted: 01/20/2020] [Indexed: 06/10/2023]
Abstract
Myofibroblastoma is a rare benign mesenchymal tumor of the breast, which tends to affect postmenopausal women and older men. It usually presents as a unilateral, well-circumscribed, firm, nontender, and freely mobile mass. We report two cases of myofibroblastoma in postmenopausal women with the imaging findings of mammography, ultrasonography, computed tomography, 18 F-Fluorodeoxyglucose-positron emission tomography computed tomography, and pathologic findings and review the relevant literature.
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Affiliation(s)
- Hyun K Jung
- Department of Diagnostic Radiology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Jung H Son
- Department of Diagnostic Radiology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Woo G Kim
- Department of Pathology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
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Akrami M, Ebrahimian S, Safaei A, Tabrizi Z, Ebrahimian S. A case report of a mammary myofibroblastoma in a male and literature review of radiologic and pathologic features of breast myofibroblastoma. Clin Case Rep 2019; 7:1968-1971. [PMID: 31624619 PMCID: PMC6787849 DOI: 10.1002/ccr3.2413] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 07/30/2019] [Accepted: 08/11/2019] [Indexed: 01/10/2023] Open
Abstract
We reported a 65-year-old male with a benign mammary myofibroblastoma. This report shows that not all masses of male breast are malignant. To differentiate benign masses from malignant neoplasms, careful preoperative diagnosis should be performed. Preoperative diagnosis of the tumor prevents placing a huge financial and mental burdens on patients.
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Affiliation(s)
- Majid Akrami
- Breast Diseases Research CenterShiraz University of Medical SciencesShirazIran
| | - Saba Ebrahimian
- Department of SurgeryLorestan university of Medical SciencesLorestanIran
| | - Akbar Safaei
- Department of PathologyShiraz University of Medical SciencesShirazIran
| | - Zhale Tabrizi
- Department of RadiologyIsfahan University of Medical SciencesIsfahanIran
| | - Shadi Ebrahimian
- Department of RadiologyIsfahan University of Medical SciencesIsfahanIran
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Lee EJ, Chang YW, Jin YM, Kim NW. Multimodality images of myofibroblastoma in the male breast: A case report and a review of the literature. Clin Imaging 2018; 51:300-306. [PMID: 29945056 DOI: 10.1016/j.clinimag.2018.06.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Revised: 06/01/2018] [Accepted: 06/06/2018] [Indexed: 12/29/2022]
Abstract
We report a case of a 58-year-old male diagnosed with myofibroblastoma using mammography, ultrasound, computed tomography (CT) and magnetic resonance imaging (MRI), as well as present a review of the literature. The pathological diagnosis was myofibroblastoma with spindle cell neoplasm with immunoreactivity. Myofibroblastoma is a rare benign disease and there is a lack of reports of multimodality imaging of this disease. We review the imaging features of this rare disease across multiple imaging modalities with pathological correlation, and provide current treatment recommendations as well.
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Affiliation(s)
- Eun Ji Lee
- Department of Radiology, Soonchunhyang University Hospital, 59 Daesakwan-ro, Yongsan-ku, Seoul 04401, Republic of Korea
| | - Yun-Woo Chang
- Department of Radiology, Soonchunhyang University Hospital, 59 Daesakwan-ro, Yongsan-ku, Seoul 04401, Republic of Korea.
| | - Yoon Mi Jin
- Department of Pathology, Soonchunhyang University Hospital, 59 Daesakwan-ro, Yongsan-ku, Seoul 04401, Republic of Korea
| | - Nam Won Kim
- Surgery, Soonchunhyang University Hospital, 59 Daesakwan-ro, Yongsan-ku, Seoul 04401, Republic of Korea
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Rochlis E, Germaine P. Radiologic presentation of a myofibroblastoma of the adult male breast. Radiol Case Rep 2017; 12:439-442. [PMID: 28828098 PMCID: PMC5552016 DOI: 10.1016/j.radcr.2017.04.025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2017] [Revised: 04/25/2017] [Accepted: 04/29/2017] [Indexed: 12/19/2022] Open
Abstract
We present the case of a 50-year-old male with bilateral gynecomastia who was incidentally found to have 0.8-cm subareolar mass on computed tomography. Mammographic and sonographic characteristics of the lesion are described as well as a brief historical review of myofibroblastoma, a rare mesenchymal tumor.
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Affiliation(s)
- Evan Rochlis
- Cooper University Hospital, 1 Cooper Plaza, Camden, NJ 08103, USA
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Raj SD, Sweetwood K, Kapoor MM, Raj KM, Nagi C, Sepulveda KA, Sedgwick EL. Spindle cell lesions of the breast: Multimodality imaging and clinical differentiation of pathologically similar neoplasms. Eur J Radiol 2017; 90:60-72. [DOI: 10.1016/j.ejrad.2017.02.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2016] [Revised: 01/11/2017] [Accepted: 02/13/2017] [Indexed: 01/13/2023]
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Omar LA, Rojanapremsuk T, Saluja K, Merchant KA, Sharma PB. Radiologic and histologic presentation of male mammary myofibroblastoma. Proc (Bayl Univ Med Cent) 2016; 29:321-2. [PMID: 27365886 DOI: 10.1080/08998280.2016.11929453] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Mammary myofibroblastoma is a rare mesenchymal neoplasm that typically presents in older men and women. Less commonly, these benign tumors may also occur in soft tissues located outside of the breast, in which case they are referred to as mammary-type myofibroblastomas. The histologic composition of this benign spindle cell tumor can be markedly varied. We present a case of a large mammary myofibroblastoma in a male patient and discuss the typical imaging and histologic makeup of these tumors.
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Affiliation(s)
- Lena A Omar
- Departments of Radiology (Omar, Merchant, Sharma) and Pathology (Rojanapremsuk, Saluja), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Theera Rojanapremsuk
- Departments of Radiology (Omar, Merchant, Sharma) and Pathology (Rojanapremsuk, Saluja), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Karan Saluja
- Departments of Radiology (Omar, Merchant, Sharma) and Pathology (Rojanapremsuk, Saluja), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kanwal A Merchant
- Departments of Radiology (Omar, Merchant, Sharma) and Pathology (Rojanapremsuk, Saluja), University of Texas Southwestern Medical Center, Dallas, Texas
| | - Pooja B Sharma
- Departments of Radiology (Omar, Merchant, Sharma) and Pathology (Rojanapremsuk, Saluja), University of Texas Southwestern Medical Center, Dallas, Texas
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Epithelioid Myofibroblastoma in an Old-Male Breast: A Case Report with MRI Findings. Case Rep Radiol 2015; 2015:934163. [PMID: 26294999 PMCID: PMC4534750 DOI: 10.1155/2015/934163] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 07/22/2015] [Indexed: 12/26/2022] Open
Abstract
Myofibroblastoma of the breast (MFB) is a very rare benign stromal tumor. In recent years, increase in mammographic screenings has resulted in increased diagnosis of MFB. Most cases are old males and postmenopausal women. MFB may be confused as malignant, clinically, morphologically, or by imaging. Immunohistochemistry is essential for final diagnosis in these cases. We report a case of a pathologically diagnosed MFB in an 80-year-old male patient who had coexisting prostate cancer and describe its imaging characteristics, especially magnetic resonance imaging (MRI). In this paper, histopathological and MRI findings of the MFB were discussed.
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Benign and Malignant Male Breast Diseases: Radiologic and Pathologic Correlation. Can Assoc Radiol J 2015; 66:198-207. [PMID: 26073217 DOI: 10.1016/j.carj.2015.01.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 01/07/2015] [Indexed: 11/21/2022] Open
Abstract
Male breast disease comprises a wide spectrum of benign and malignant processes. We present the spectrum of diseases encountered at our institution over the past 7 years (2007-2013) and correlate their radiological and histopathological appearances. Gynaecomastia is the most frequently encountered disease due to its association with a variety of causes. Male breast malignancies, though rare, must be considered. The most frequently encountered pathological characteristic is invasive and the predominant histologic subtypes are infiltrating ductal carcinomas.
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Mesenchymal breast lesions. Clin Radiol 2015; 70:567-75. [DOI: 10.1016/j.crad.2014.12.015] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2014] [Revised: 12/11/2014] [Accepted: 12/18/2014] [Indexed: 12/18/2022]
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Lattin GE, Jesinger RA, Mattu R, Glassman LM. From the radiologic pathology archives: diseases of the male breast: radiologic-pathologic correlation. Radiographics 2013; 33:461-89. [PMID: 23479708 DOI: 10.1148/rg.332125208] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Male breast disease includes a variety of benign and malignant conditions, many of which are hormonally influenced. Gynecomastia and skin lesions account for the majority of conditions in symptomatic men with a palpable abnormality, and these conditions should be accurately recognized. Imaging patterns of gynecomastia include nodular, dendritic, and diffuse patterns. Histopathologically, the nodular and dendritic patterns correlate with the florid and quiescent (fibrotic) phases of gynecomastia, respectively. The diffuse pattern may have features of both phases and is associated with exposure to exogenous estrogen. Benign-appearing palpable masses in male patients should be approached cautiously, given the overlapping morphologic features of benign and malignant tumors. In addition to gynecomastia, other benign male breast tumors include lipoma, pseudoangiomatous stromal hyperplasia, granular cell tumor, fibromatosis, myofibroblastoma, schwannoma, and hemangioma. Male breast cancer accounts for 1% of all breast carcinomas. Invasive ductal carcinoma accounts for the majority of cases in adult males and typically appears as a subareolar mass without calcifications that is eccentric to the nipple. Other epithelial and mesenchymal tumors that may occur, albeit not as commonly as in women, include papillary carcinoma, invasive lobular carcinoma, adenoid cystic carcinoma, liposarcoma, dermatofibrosarcoma, pleomorphic hyalinizing angiectatic tumor, basal cell carcinoma of the nipple, hematopoietic malignancies, and secondary tumors. Knowledge of the natural history, clinical characteristics, and imaging features of tumors that occur in the male breast will help narrow the radiologic differential diagnosis and optimize treatment.
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Affiliation(s)
- Grant E Lattin
- Department of Radiology and Radiological Sciences, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA.
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Imagerie du sein de l’homme. IMAGERIE DE LA FEMME 2011. [DOI: 10.1016/j.femme.2011.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yoo EY, Shin JH, Ko EY, Han BK, Oh YL. Myofibroblastoma of the female breast: mammographic, sonographic, and magnetic resonance imaging findings. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:1833-1836. [PMID: 21098856 DOI: 10.7863/jum.2010.29.12.1833] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Affiliation(s)
- Eun Young Yoo
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Santamaría G, Velasco M, Bargalló X, Caparrós X, Farrús B, Luis Fernández P. Radiologic and pathologic findings in breast tumors with high signal intensity on T2-weighted MR images. Radiographics 2010; 30:533-48. [PMID: 20228333 DOI: 10.1148/rg.302095044] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Various histopathologic components in benign and malignant breast lesions may generate hyperintense signal at T2-weighted magnetic resonance (MR) imaging. A comparison of the specific histologic features found in breast lesions with a high-signal-intensity appearance on unenhanced T2-weighted turbo spin-echo MR images obtained without spectral fat suppression shows that this MR imaging characteristic is often suggestive of the differential diagnosis. Histopathologic features that may produce high signal intensity in breast lesions include extensive necrosis, a cystic or microcystic component, an adipose or sebaceous component, mucinous stroma, loose myxoid stroma, stromal edema, and hemorrhagic changes. A more nuanced understanding of the correlation between the MR imaging appearance and specific pathologic findings may help radiologists achieve earlier and more accurate differentiation among this group of breast lesions.
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Affiliation(s)
- Gorane Santamaría
- Departments of Radiology, Gynecology and Obstetrics, Radiation Oncology, and Pathology, Hospital Clinic and University of Barcelona School of Medicine, Villarroel 170, 08036 Barcelona, Spain.
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Magro G. Mammary Myofibroblastoma: A Tumor With a Wide Morphologic Spectrum. Arch Pathol Lab Med 2008; 132:1813-20. [DOI: 10.5858/132.11.1813] [Citation(s) in RCA: 129] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2008] [Indexed: 12/20/2022]
Abstract
Abstract
Context.—Myofibroblastoma (MFB) of the breast is an unusual benign tumor that belongs to the family of the “benign spindle cell tumors of the mammary stroma.” The name MFB reflects its cellular composition, comprising mainly stromal cells with fibromyofibroblastic and, less frequently, myoid differentiation. Since the original description, the morphologic spectrum of MFB has been expanded by the recognition of several unusual morphologic variants, such as the cellular, infiltrative, epithelioid, deciduoid-like, lipomatous, collagenized/fibrous, and myxoid variants.
Objective.—To review the literature on mammary MFB, discussing the main clinical, radiologic, and pathologic features helpful for diagnosis. Since MFB may show alarming morphologic features, which can lead to a misdiagnosis of malignancy, histologic figures of this tumor, including its more unusual variants, are provided to offer pathologists a practical approach to a correct diagnosis. Histogenesis and pathogenesis of this tumor are also proposed.
Data Sources.—Clinicopathologic data on MFB were extracted from all identified articles through PUB Medline– based research. Histologic figures have been taken from the personal archive of the author.
Conclusions.—The incidence of MFB diagnosis has increased in recent years, likely due to the mammographic screening. Accordingly, this unusual benign tumor may represent a potential diagnostic pitfall, especially when interpreting fine-needle aspiration and/or needle core biopsy. Pathologists should be aware of the wide morphologic spectrum exhibited by MFB to avoid a misdiagnosis of malignancy.
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Affiliation(s)
- Gaetano Magro
- From the Dipartimento G.F. Ingrassia, Policlinico Universitario G. Rodolico, Anatomia Patologica, Università di Catania, Catania, Italy
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Günhan-Bilgen I, Bozkaya H, Ustün EE, Memiş A. Male breast disease: clinical, mammographic, and ultrasonographic features. Eur J Radiol 2002; 43:246-55. [PMID: 12204407 DOI: 10.1016/s0720-048x(01)00483-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
PURPOSE To describe and quantitate the radiological (mammographic and ultrasonographic) characteristics of male breast disease and to report the clinical and pathological findings. MATERIALS AND METHODS Two-hundred-thirty-six male patients with different male breast diseases, diagnosed at our institution between January 1990 and July 2001, were retrospectively evaluated. The history, physical examination, mammographic and ultrasonographic findings were analyzed. RESULTS The spectrum of the disease in 236 male patients were gynecomastia (n=206), primary breast carcinoma (n=14), fat necrosis (n=5), lipoma (n=3), subareolar abscess (n=2), epidermal inclusion cyst (n=1), sebaceous cyst (n=1), hematoma (n=1), myeloma (n=1), and metastatic carcinoma (n=2). The distribution of patterns of gynecomastia were; 34% (n=71) nodular, 35% (n=73) dendritic and 31% (n=62) diffuse glandular. Gynecomastia was unilateral in 55% (n=113) and bilateral in 45% (n=93) of the patients. Male breast cancer presented as a mass without microcalcifications in 86% (n=12) and with microcalcifications in 7% (n=1) of patients. The mass was obscured by gynecomastia, partially in two, totally in one patient. The location of the mass was retroareolar in 46% (n=6) and eccentric to the nipple in 54% (n=7) of patients. On ultrasonography (US), the contours were well-circumscribed in 20% (n=3) and irregular in 80% (n=12) of the masses. CONCLUSION Male breast has a wide spectrum of diseases, some of which have characteristic radiological appearances that can be correlated with their pathologic diagnosis. In the evaluation of the male breast, mammography and US are essential and should be performed along with physical examination.
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Affiliation(s)
- Işil Günhan-Bilgen
- Department of Radiology, Ege University Hospital, Bornova 35100, Izmir, Turkey.
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