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Olinger K, Maheshwari E, Shenoy-Bhangle AS, Adejolu M, McGettigan M, Mathew H, Lee KS, Nicola R. Mimics of cancer in pregnancy. ABDOMINAL RADIOLOGY (NEW YORK) 2022; 48:1752-1773. [PMID: 36577923 DOI: 10.1007/s00261-022-03783-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/13/2022] [Accepted: 12/14/2022] [Indexed: 12/30/2022]
Abstract
Pregnancy is a remarkable time of pronounced growth and development of the fetus. Benign pathologies outside of the uterus, including those containing hormonally responsive tissue which undergo physiologic changes and other incidentally identified lesions, may mimic malignancy on clinical evaluation and imaging. A detailed history and physical exam, ultrasound and non-contrast magnetic resonance imaging features and comparison with prior imaging if available may help to narrow the list of potential differential diagnoses. Follow-up imaging in the postpartum period is often vital to confirm benignity and, in some cases, sampling to confirm the diagnosis is necessary. This review will cover the clinical, pathological and multimodality imaging features of numerous potential mimickers of cancer in the setting of pregnancy organized by organ systems. The goal is to better equip abdominal radiologists to accurately identify benign disease and help guide further imaging or follow-up recommendations to avoid unnecessarily aggressive intervention and improve patient care.
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Affiliation(s)
- Kristen Olinger
- Division of Abdominal Radiology, Department of Radiology, University of North Carolina at Chapel Hill, 2021 Old Clinic Building, Chapel Hill, NC, 27599, USA.
| | - Ekta Maheshwari
- Division of Abdominal Imaging, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, 15143, USA
| | - Anuradha S Shenoy-Bhangle
- Division of Abdominal Radiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, 02214, USA
| | - Margaret Adejolu
- Department of Radiology, The Royal Marsden Hospital, London, England, UK
| | | | | | - Karen S Lee
- Division of Abdominal Radiology, Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, 02215, USA
| | - Refky Nicola
- Division of Abdominal Imaging, Department of Radiology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA
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Dafaalla H, Khougali HS, Malassi Y. Bilateral complex lactating adenosis: Clinical presentation and management in Sudan. Clin Case Rep 2021; 9:e05213. [PMID: 34938564 PMCID: PMC8667293 DOI: 10.1002/ccr3.5213] [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: 07/10/2021] [Revised: 10/26/2021] [Accepted: 11/09/2021] [Indexed: 11/25/2022] Open
Abstract
Lactating adenosis is a benign breast neoplasm usually seen during pregnancy and lactation. We present a rare case of bilateral complex benign lactating adenosis in 19-year-old female patient presented with lactating adenosis that mimics cancer growth after giving birth. Histopathology confirmed diagnosis. Simple mastectomy was the treatment of choice.
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Affiliation(s)
- Hatoun Dafaalla
- Department of General SurgeryWad‐Medani Teaching HospitalWad‐MedaniSudan
| | | | - Yussra Malassi
- Department of Research and MethodologyIbn‐Seina HospitalKhartoumSudan
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Moulaz IR, de Oliveira FSS, da Silva EC, Machado JM, Santos MCLFS. Giant lactating adenoma. AUTOPSY AND CASE REPORTS 2021; 11:e2021252. [PMID: 33968827 PMCID: PMC8087397 DOI: 10.4322/acr.2021.252] [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] [Indexed: 11/23/2022] Open
Abstract
Lactating adenoma is a rare benign breast lesion that most often presents as a small (up to 3 cm), solid, well-circumscribed, solitary, painless, mobile, lobulated mass. The highest incidence occurs in primiparous women (20 to 40 years old) during the third trimester of pregnancy. However, in the rare case presented herein, in addition to its giant size (more than 10 centimeters on palpation), this lactating adenoma is distinctive due to the presence of multiple nodules, poorly defined ultrasonographic margins, worrisome radiologic features, growth since early pregnancy, presence of infarction and association with chronic mastitis. From the clinical-radiologic perspective, the differential diagnoses included abscess associated with puerperal mastitis, phyllodes tumor, and galactocele. Biopsy was performed, and pathologic examination revealed the classic characteristics of lactating adenoma with multiple infarcted areas, leading to an unexpected confirmed case of giant lactating adenoma.
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Affiliation(s)
| | | | - Eveline Cristina da Silva
- Universidade Federal do Espírito Santo, Medical School, Department of Pathology, Vitória, ES, Brasil
| | - Janine Martins Machado
- Universidade Federal do Espírito Santo, Medical School, Department of Obstetrics and Gynecology, Vitória, ES, Brasil
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Phung HT, Nguyen LT, Nguyen HV, Nguyen CV, Nguyen HT. Aggressive lactating adenoma mimicking breast carcinoma: A case report. Int J Surg Case Rep 2020; 70:17-19. [PMID: 32348915 PMCID: PMC7191075 DOI: 10.1016/j.ijscr.2020.03.047] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 03/17/2020] [Accepted: 03/30/2020] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION Lactating adenoma is a rare breast tumor which is commonly found in late pregnancy or lactation period. Despite its benign nature, lactating adenoma might develop aggressively and can be misdiagnosed as breast cancer. CASE PRESENTATION We report a case of a 25-year-old female presenting with two large, ulcerative and bleeding breast masses. An open biopsy demonstrating lactating adenoma was considered discordant and surgery was performed to confirm the diagnosis. CONCLUSION Careful clinical and histological evaluations are necessary to diagnose and manage lactating adenoma.
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Affiliation(s)
- Huyen Thi Phung
- Department of Medical Oncology 6, Vietnam National Cancer Hospital, Hanoi, Viet Nam; Department of Oncology, Vietnam University of Traditional Medicine, Hanoi, Viet Nam
| | | | - Hung Van Nguyen
- Department of Oncology, Hanoi Medical University, Hanoi, Viet Nam; Department of Oncology and Palliative Care, Hanoi Medical University Hospital, Hanoi, Viet Nam
| | - Chu Van Nguyen
- Quan Su Pathology Department, Vietnam National Cancer Hospital, Hanoi, Viet Nam
| | - Hoa Thi Nguyen
- Department of Medical Oncology 6, Vietnam National Cancer Hospital, Hanoi, Viet Nam
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Efared B, Sidibé IS, Abdoulaziz S, Hammas N, Chbani L, El Fatemi H. Tubular Adenoma of the Breast: A Clinicopathologic Study of a Series of 9 Cases. Clin Med Insights Pathol 2018; 11:1179555718757499. [PMID: 29449780 PMCID: PMC5808954 DOI: 10.1177/1179555718757499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 01/10/2018] [Indexed: 11/15/2022] Open
Abstract
Tubular adenoma of the breast is one of the most rare benign neoplasms, accounting for only 0.13% to 1.7% of all breast benign tumors. Little is known about this rare neoplasm as the current literature offers only some case reports or a few number of small series. The aim of our study is to provide some clinicopathologic features of the breast tubular adenoma. We retrospectively analyzed at our department of pathology all cases of breast tubular adenomas confirmed by immunohistochemistry over a period of 9 years (2009-2017). Nine cases of breast tubular adenoma have been recorded, with an average age of 31.44 years. Five tumors were located at the right side (55.55%), and most cases had suspicious aspects on imaging techniques (6 cases out of 9). The diagnosis has been made on 5 resected specimens (lumpectomy) and on 4 core needle biopsies. The tumor size ranged from 0.9 to 7 cm (mean size of 3.08 cm) and had well-circumscribed margins with elastic consistency. The histopathologic analysis showed a typical pattern of proliferating round and uniform tubules lined by regular epithelial cells surrounded by myoepithelial cells, packed in a small amount of stroma, highlighted by CD34 immunostaining. Tubular adenoma is a rare breast benign neoplasm of young premenopausal women. The radiologic aspects are often worrisome and only the histopathologic analysis can achieve the correct definitive diagnosis by excluding all potential differential diagnoses.
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Affiliation(s)
- Boubacar Efared
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
| | - Ibrahim S Sidibé
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
| | - Souley Abdoulaziz
- Department of Radiology, Hassan II University Hospital, Fès, Morocco
| | - Nawal Hammas
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Laila Chbani
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Hinde El Fatemi
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
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