Surgery for fibroadenoma arising from axillary accessory breast

Benign Phyllodes Tumor of Axillary Tail USG and Elastography Evaluation with Histopathological Correlation

The axillary tail, also known as spencer's tail or axillary process, is a continuation of tissue from the upper lateral quadrant of the breast that travels into the axilla through a foramen of Langer in the deep fascia. Axillary inflammation or lump is a typical clinical symptom that necessitates imaging evaluation. Since the axilla consists of lymph nodes as well as nonlymphatic tissue such as accessory breast tissue, skin, fat, muscles, nerves, and blood vessels, it has a wide variety of differential diagnoses. The radiologists should be well acquainted with axillary anatomy and imaging aspects of various axillary lesions. Here, we present a 35-year-old female with a right axillary lump which was suggestive of benign tumor on ultrasonography and was proven to be benign phyllodes tumor on histopathology.

A Case of Axillary Fibroadenoma That Grew Rapidly from Axillary Accessory Breast Tissue over 40 Days

Axillary accessory breast (AAB) occurs in 2%-6% of women. Like normal breast tissue, ABB can undergo changes, including periodic enlargement that can result in a palpable axillary mass. Fibroadenoma is the most common benign subcutaneous tumor of the breast: it occurs in approximately 25% of women and accounts for 50% of all breast biopsies. However, fibroadenoma in AAB is rare (2.6%). Here, we describe the case of a patient who was diagnosed first with left AAB on the basis of clinical and magnetic imaging resonance findings, and then 40 days later with fibroadenoma in left AAB by histopathology of the resected mass. The tumor, which had been undetectable at the initial visit, had transformed into a clinically obvious, hard, protruding mass at surgery. Thus, fibroadenomas originating from AAB can grow quickly, and imaging-based diagnosis should be confirmed with histology. Treatment should involve complete excision of the fibroadenoma and surrounding AAB.

Fibroadenoma in axillary breast tissue - Utility of rapid on-site evaluation & report of two cases

ABSTRACT

Fibroadenoma of axillary breast tissue presents as a palpable mass, cyclic pain in the axilla, and with asthetic concerns. Axillary breast tissue can occur anywhere along the primitive embryonic milk lines, extending from the axilla to the groin, and can present unilaterally or bilaterally. The reported incidence of axillary breast tissue is 0.4%-6% in females. We had two cases of fibroadenoma in the axilla that were diagnosed on rapid on-site evaluation and later confirmed by routine cytology stains in young females. We report the cases for their rarity and high degree of clinical suspicion in the young reproductive age group female. We also emphasize the utility of ROSE in cytopathology.

Fibroadenoma: a guide for junior clinicians

Fibroadenoma is the most common cause of benign breast lumps and is typically seen in women under the age of 40 years. Fibroadenomas are classified as simple, complex, giant, myxoid or juvenile. They present as smooth, rubbery, mobile masses on palpation. Ultrasonographic and mammographic features typical of fibroadenomas include solid, round, well-circumscribed masses, with or without lobulated features. They are predominantly treated conservatively although clinical pathways recommend referral for triple assessment. Surgical intervention is indicated by the presence of one or more of the following features: the presence of symptoms, a diameter greater than 2 cm, rapid growth rate, complex features, disease recurrence or patient anxiety.

Fibroadenoma in axillary ectopic breast

Axillary lumps are common clinical presentations in surgery, which have various differential diagnoses. We encountered an unusual case of an isolated axillary mass. The patient was a young woman in her 20s with a 2 year history of right axillary swelling. Clinically, the lump measured 3 cm ×3 cm, mobile, non-tender, and there was no associated breast lump or skin changes. Our initial impression was an isolated lymphadenopathy, and further workup for tuberculosis lymphadenopathy returned negative. Ultrasound demonstrated a well circumscribed oval lesion, and fine needle aspiration could only identify a benign proliferative breast tissue. As it was increasing in size and causing discomfort, we decided for an excision biopsy for both diagnostic and therapeutic reasons. Intraoperatively, the lump was noted to have well defined, smooth surface along with whitish-grey appearance. The tissue surrounding it was also removed and sent for histopathological assessment. Results confirmed our diagnosis of fibroadenoma in an ectopic breast tissue.

Fibroadenoma in axillary accessory breast mimicking carcinoma of unknown primary; a case report with literature review

Introduction

Accessory breast (AB) is extra and ectopic breast tissue. Fibroadenoma (FA) in AB is a rare finding. This study aims to present a case of FA in axillary AB mimicking carcinoma of unknown primary (CUP).

Case report

A 38-year-old female presented with a mass in her right axilla. She had a mass in her right breast for 5 years. She previously had a left breast lumpectomy for a benign condition. The lump in her axilla was palpable and hard. Ultrasound showed an oval lymph node in the level I axilla (12*6mm) with blurred and unclear fatty hilum, suspicious for malignancy. Magnetic resonance imaging revealed an oval lesion (12*7mm) in the level I axilla with no fatty hilum and with heterogeneous enhancements, suggesting abnormal nodes. Fine needle aspiration of the axillary mass suspected CUP. But core biopsy resembled FA. Both masses in the right axilla and breast were surgically excised. Histopathology confirmed FA in both masses.

Discussion

Although pathologies in AB are uncommon, it is still susceptible to the same malignant and benign transformations that are found in normal breasts. The axilla is the most frequent location for FA in AB and often affects young women. Imaging techniques can be inconclusive and only histopathology can conclude a definitive diagnosis.

Conclusion

FA in axillary AB is a rare condition that causes a diagnostic dilemma as it can be mistaken for other benign or malignant pathologies.

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Accessory breast is having extra and ectopic breast tissue.

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Fibroadenoma in the accessory breast is a very rare finding.

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It can be mistaken for other malignant pathologies.

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This report presents a case of fibroadenoma in axillary accessory breast mimicking carcinoma of unknown primary.

Fibroadenoma of Axillary Ectopic Breast Tissue

Teaching point: Ectopic breast fibroadenoma is a rare benign neoplasm that may mimic pathological lymph node clinically and on imaging.

Fibroadenoma in a suprapubic accessory breast

Ectopic breast tissue (EBT) is relatively common and can occur along the milk line or mammary ridge and often outside this line. We report a case of a female patient presenting with a suprapubic mass for 2 years, found later to be EBT containing a fibroadenoma. We believe this is a very rare finding. Moreover, we highlight the importance of considering EBT in the differential diagnoses of soft tissue masses.