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Thomas M, Al Kashroom H, Reddy S, Zaccarini D, Willer K. Male Breast Cancer: Imaging Considerations for Diagnosis and Surveillance. J Clin Med Res 2024; 16:197-207. [PMID: 38855781 PMCID: PMC11161189 DOI: 10.14740/jocmr5169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Accepted: 05/13/2024] [Indexed: 06/11/2024] Open
Abstract
Male breast cancer accounts for less than 1% of all breast cancer cases. The important risk factors for the development of male breast cancer are family history, genetic mutations, obesity, liver disease, alcoholism, exogenous estrogen administration, and radiation exposure to the chest area. Despite its rarity, numerous studies have investigated the data on imaging considerations (mammogram, ultrasound, and magnetic resonance imaging (MRI)), but have addressed only certain aspects of male breast cancer. A comprehensive approach on the imaging characteristics, timing of imaging, prognostication based on imaging characteristics, and follow-up strategies in male breast cancer are still lacking. The purpose of this review article was to provide a comprehensive overview of the imaging findings, optimal timing to obtain imaging, and the appropriate follow-up strategies in male breast cancer survivors. This article also describes how imaging modalities can aid in determining prognosis. By addressing this knowledge gap, the article provides valuable insights for clinicians managing this uncommon yet clinically significant disease.
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Affiliation(s)
- Mathew Thomas
- Department of Internal Medicine, State University of New York (SUNY) Upstate, Syracuse, NY, USA
| | - Hatem Al Kashroom
- Department of Radiology, State University of New York (SUNY) Upstate, Syracuse, NY, USA
| | - Shilpa Reddy
- Department of Pathology, State University of New York (SUNY) Upstate, Syracuse, NY, USA
| | - Daniel Zaccarini
- Department of Pathology, State University of New York (SUNY) Upstate, Syracuse, NY, USA
| | - Katherine Willer
- Department of Radiology, State University of New York (SUNY) Upstate, Syracuse, NY, USA
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2
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Bancroft A, Santa Cruz J, Levett K, Nguyen QD. Incidental Breast Hemangioma on Breast MRI: A Case Report. Cureus 2024; 16:e57903. [PMID: 38725792 PMCID: PMC11079714 DOI: 10.7759/cureus.57903] [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] [Accepted: 04/09/2024] [Indexed: 05/12/2024] Open
Abstract
Vascular tumors of the breast are rare, but benign hemangiomas are the most common type. Capillary hemangiomas are a subset of benign vascular tumors that involve smaller vessel sizes. They are difficult to diagnose with mammography and ultrasound, as they lack pathognomonic features and are frequently not seen. MRI is the most sensitive imaging tool. The lesions appear similar to angiosarcoma or ductal carcinoma in situ on imaging, which further complicates the diagnosis. A biopsy of the lesions is required for a definitive diagnosis. In this report, a 49-year-old female with newly diagnosed breast cancer is incidentally found to have a capillary hemangioma on staging breast MRI that was confirmed with a biopsy and excised along with the primary breast cancer with a partial mastectomy. The imaging findings of breast hemangioma on mammography, ultrasound, and MRI are also reviewed and described in this report.
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Affiliation(s)
| | | | - Kaitlyn Levett
- Pathology and Immunology, Baylor College of Medicine, Houston, USA
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3
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Braun A, Solari M, Gattuso P, Agarwal I. Benign Vascular Lesions of the Breast: A Clinical, Radiographic, and Pathologic Review. Int J Surg Pathol 2023; 31:1437-1448. [PMID: 37032453 DOI: 10.1177/10668969231160254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
Vascular lesions of the breast are uncommon, however, these are increasingly encountered now due to more frequent use of magnetic resonance imaging. They comprise a spectrum of lesions including benign, atypical, and malignant tumors. The prototype is a hemangioma, which is most often nonpalpable and is detected on routine screening. Different histopathologic subtypes of hemangioma have been described, including perilobular, venous, cavernous, and capillary hemangioma. Other benign vascular lesions include anastomosing hemangioma, a well-circumscribed proliferation of anastomosing blood vessels with lobular or diffuse growth pattern which affects a large segment of the breast, presenting as a painless slow enlarging palpable mass. Recent data suggest that benign vascular lesions diagnosed on core needle biopsy with concordant radiologic and pathologic findings do not require excision and have an excellent prognosis, except angiomatosis, which can be locally aggressive and may recur. The main focus of this study is to present the radiographic, gross, and histopathologic characteristics of benign vascular lesions of the breast and their differential diagnoses.
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Affiliation(s)
- Ankica Braun
- Rush University Medical Center, Department of Pathology, Chicago, IL, USA
| | - Mariana Solari
- Rush University Medical Center, Department of Pathology, Chicago, IL, USA
- Rush University Medical Center, Department of Radiology, Chicago, IL, USA
| | - Paolo Gattuso
- Rush University Medical Center, Department of Pathology, Chicago, IL, USA
| | - Indu Agarwal
- Rush University Medical Center, Department of Radiology, Chicago, IL, USA
- Northwestern University, McGaw Medical Center, Department of Pathology, Chicago, IL, USA
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4
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AlSharif S, Alshamrani KM, Scaranelo A, Khoumais N, Subahi A, Mesurolle B. Unusual Male Breast Lesions. J Clin Imaging Sci 2021; 11:21. [PMID: 33948337 PMCID: PMC8088480 DOI: 10.25259/jcis_43_2021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Accepted: 03/18/2021] [Indexed: 12/18/2022] Open
Abstract
Most of male breast masses are benign with gynecomastia being the most common entity encountered. Primary male breast cancer accounts for less than 1% of the total number of breast cancer. Male breast can be affected by a variety of conditions affecting the female breast with less frequency due to the lack of hormonal influence and consequent glandular sub-development. Imaging features of male breast masses are quite similar to the female breast. Therefore, using the knowledge of the female breast and applying it may help in the diagnosis and management of male breast abnormalities. In this article, we aim to review a variety of unusual male breast masses. We discuss the demographics of male breast tumors, describe the diagnostic algorithm for evaluating male breast masses, and review the imaging features of rare breast masses and mimickers of male breast cancer.
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Affiliation(s)
- Shaza AlSharif
- Department of Medical Imaging, Ministry of the National Guard - Health Affairs, Saudi Arabia.,Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Khalid Misfer Alshamrani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Anabel Scaranelo
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Nuha Khoumais
- Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ahmad Subahi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia.,Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Benoit Mesurolle
- Department of Radiology, Pôle Santé République, Clermont-Ferrand, France
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5
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Chesebro AL, Rives AF, Shaffer K. Male Breast Disease: What the Radiologist Needs to Know. Curr Probl Diagn Radiol 2019; 48:482-493. [DOI: 10.1067/j.cpradiol.2018.07.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Accepted: 07/17/2018] [Indexed: 12/20/2022]
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6
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Kim SH, Kim YS. Ultrasonographic and Mammographic Findings of Male Breast Disease. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2019; 38:243-252. [PMID: 29708282 DOI: 10.1002/jum.14665] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 03/22/2018] [Accepted: 03/23/2018] [Indexed: 06/08/2023]
Abstract
Most male breast diseases are benign, although malignancies can also occur. Gynecomastia, the most common abnormality in the male breast, has characteristic imaging findings differentiating it from cancer. Fewer than 1% of patients with breast cancer are men, but the incidence of male breast cancer is increasing worldwide. Additionally, breast cancer often presents at a more advanced stage in men than in women due to delayed diagnosis. Understanding imaging features of male breast disease is important for an accurate diagnosis and optimal care. This article reviews ultrasonography and mammography findings of benign and malignant diseases of the male breast.
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Affiliation(s)
- Su Hong Kim
- Department of Radiology, College of Medicine, Yeungnam University, Daegu, Korea
| | - Young-Seon Kim
- Department of Radiology, College of Medicine, Yeungnam University, Daegu, Korea
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7
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Yoga A, Lyapichev KA, Baek D, Gomez-Fernandez CR. Hemangioma of a Male Breast: Case Report and Review of the Literature. AMERICAN JOURNAL OF CASE REPORTS 2018; 19:1425-1429. [PMID: 30498190 PMCID: PMC6287655 DOI: 10.12659/ajcr.911842] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND Male breast hemangioma is a rare benign neoplasm that is usually excised for definitive diagnosis. CASE REPORT In our case report, we present a male octogenarian with multiple comorbidities who presented with a large palpable mass in his right breast. The diagnostic imaging studies were suggestive of a benign tumor, with a BI-RADS (Breast Imaging Reporting and Data System) score of 3. Subsequent core needle biopsies were diagnostic of benign hemangioma. The patient was managed with observation due to his comorbidities. Benign vascular tumors in the male breast are exceptionally rare, and in our review of the literature we found only 14 previously published cases. Historically, fine needle aspiration has been found to be unreliable in making a definitive diagnosis and surgical excision has been the standard treatment. CONCLUSIONS Recent studies and our case report indicate that core needle biopsy may be a reliable diagnostic tool and observation is a possible option for hemangiomas in male patients who cannot undergo surgery.
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Affiliation(s)
- Arthy Yoga
- Department of Breast Surgery, Texas Oncology, Houston, TX, USA.,Division of Breast Surgery, Department of Surgery, Bethesda Health System, Boynton Beach, FL, USA
| | - Kirill A Lyapichev
- Department of Pathology and Laboratory Medicine, University of Miami, Miami, FL, USA.,Department of Hematopathology, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA
| | - Donghwa Baek
- Department of Pathology and Laboratory Medicine, University of Miami, Miami, FL, USA.,Department of Pathology and Genomic Medicine, Methodist Hospital, Houston, TX, USA
| | - Carmen R Gomez-Fernandez
- Department of Pathology and Laboratory Medicine, University of Miami, Miami, FL, USA.,Sylvester Comprehensive Cancer Center, Miami, FL, USA
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8
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Väre T, Galassi FM, Niinimäki J, Junno JA. Potential case of gynecomastia in mummified remains of an early modern period northern finnish vicar. Clin Anat 2018; 31:641-644. [PMID: 29664129 DOI: 10.1002/ca.23187] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2018] [Accepted: 04/13/2018] [Indexed: 11/09/2022]
Abstract
We report possibly the oldest evidence of gynecomastia in mummified human remains. Computed tomography was performed on the mummified remains of an early 17th century Northern Finnish vicar. The examination of the scans revealed large bilateral subareolar irregular masses resembling female mammary glands. The nearly septuagenarian vicar appears to have had gynecomastia, as it is a common condition in elderly men, and is sometimes associated with obesity. Gynecomastia is the most likely explanation for these findings. Clin. Anat. 31:641-644, 2018. © 2018 Wiley Periodicals, Inc.
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Affiliation(s)
- Tiina Väre
- Department of Archeology, Faculty of Humanities, University of Oulu, Oulu, FI-90014, Finland.,Medical Research Center of University of Oulu and Oulu University hospital, Oulu, 90014, Finland
| | - Francesco M Galassi
- Institute of Evolutionary Medicine, University of Zurich, Zurich, 8057, Switzerland
| | - Jaakko Niinimäki
- Center for Medical Imaging, Physics and Technology Research of University of Oulu and Oulu University hospital, Oulu, FI-90029, Finland
| | - Juho-Antti Junno
- Department of Archeology, Faculty of Humanities, University of Oulu, Oulu, FI-90014, Finland.,Medical Research Center of University of Oulu and Oulu University hospital, Oulu, 90014, Finland
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9
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Aydın OU, Soylu L, Ercan Aİ, Bilezikçi B, Özbaş S. Cavernous Hemangioma in the Breast. THE JOURNAL OF BREAST HEALTH 2015; 11:199-201. [PMID: 28331722 DOI: 10.5152/tjbh.2015.2421] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/19/2015] [Indexed: 11/22/2022]
Abstract
Although the observation of breast vascular tumors is rare, the most common tumor is hemangıoma in the benign group, and these tumors are observed incidentally in lumpectomy or mastectomy specimens during histological examinations. They are classified into capillary, cavernous, and venous hemangıomas. Cavernous hemangıoma is the most common subtype. Cavernous hemangıomas are benign vascular tumors, which malformatıon from mature blood vessels. Hemangıomas ın the benıgn group may show a suspicion of ductal carcinoma in situ (DCIS) in mammographic analysis. Ultrasonography (US) and magnetic resonance ımagıng (MRI) are the most useful imaging methods for analyzing the structure of breast vessels. In this case, a 54-year-old female who have any complaint. Scanning mammography (MG) detected the tumor, but physıcal examınatıon and US could not identify the mass. According to the MG analysis, the lesion was evaluated as BIRADS 4b, and the patient underwent excisional biopsy after wire localization. Pathological analysis revealed cavernous hemangıoma.
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Affiliation(s)
- Oğuz Uğur Aydın
- Clinic of General Surgery, Ankara Private Güven Hospital, Ankara, Turkey
| | - Lütfi Soylu
- Clinic of General Surgery, Ankara Private Güven Hospital, Ankara, Turkey
| | | | - Banu Bilezikçi
- Clinic of Pathology, Ankara Private Güven Hospital, Ankara, Turkey
| | - Serdar Özbaş
- Clinic of General Surgery, Ankara Private Güven Hospital, Ankara, Turkey
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10
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Madhukar M, Chetlen A. Multimodality imaging of benign and malignant male breast disease. Clin Radiol 2013; 68:e698-706. [DOI: 10.1016/j.crad.2013.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2013] [Revised: 07/09/2013] [Accepted: 07/10/2013] [Indexed: 10/26/2022]
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11
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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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12
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Popli MB, Popli V, Bahl P, Solanki Y. Pictorial essay: Mammography of the male breast. Indian J Radiol Imaging 2011; 19:278-81. [PMID: 19881102 PMCID: PMC2797738 DOI: 10.4103/0971-3026.57207] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Mammography is an imaging modality that is widely perceived to be of use only in women for the detection and diagnosis of breast pathologies. Here, we present a pictorial essay on the mammographic spectrum of male breast pathologies.
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Affiliation(s)
- Manju Bala Popli
- Department of Radiological Imaging and NMR Research Centre, Institute of Nuclear Medicine and Allied Sciences (INMAS), Lucknow Road, Delhi - 110 054, India
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13
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Leddy R, Cluver A. Mammographic and sonographic characteristics of a cavernous hemangioma in a male patient. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:645-649. [PMID: 20375384 DOI: 10.7863/jum.2010.29.4.645] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Rebecca Leddy
- Department of Radiology, MSC 323, Medical University of South Carolina, 96 Jonathan Lucas St, Room 210 CSB, Charleston, SC 29425-3230, USA.
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14
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Kawatra V, Lakshmikantha A, Dhingra KK, Gupta P, Khurana N. A rare coexistence of concurrent breast hemangioma with fibroadenoma: a case report. CASES JOURNAL 2009; 2:7005. [PMID: 19829893 PMCID: PMC2740063 DOI: 10.1186/1757-1626-2-7005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/21/2008] [Accepted: 03/18/2009] [Indexed: 12/02/2022]
Abstract
We report the case of a 38-year-old Asian, Indian female with capillary hemangioma breast in coexistence with the commonly occurring fibroadenoma. Clinical examination of the breast revealed a 4 cm diameter lump. Mammography revealed a well defined slightly hypoechoic lesion with smooth contours. A lumpectomy was performed. Histopathology confirmed the diagnosis of a completely encapsulated fibroadenoma coexistent with a capillary hemangioma in the adjacent breast tissue. The rarity of literature on breast hemangioma especially capillary type with coexisting fibroadenoma deserves mention.
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Affiliation(s)
- Vibha Kawatra
- Department of Pathology, Maulana Azad Medical College and Lok Nayak Hospital Bahadur Shah Zafar Marg, New Delhi -110002 India.
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15
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16
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Affiliation(s)
- Michael Darcy
- Department of Interventional Radiology, Mallinckrodt Institute of Radiology, 510 S. Kingshighway Blvd., St. Louis, MO 63110, USA.
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