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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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2
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Adhikari S, Bhatta OP, Bhetwal P. Cavernous hemangioma of the breast: a case report. Ann Med Surg (Lond) 2024; 86:561-564. [PMID: 38222768 PMCID: PMC10783268 DOI: 10.1097/ms9.0000000000001532] [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: 09/12/2023] [Accepted: 11/12/2023] [Indexed: 01/16/2024] Open
Abstract
Background Hemangioma is a common benign tumor resulting from abnormal blood vessel growth but is infrequent in the breast. Preoperatively, it is challenging to diagnose breast hemangioma using clinical and conventional imaging modalities because of their lack of pathognomonic characteristics. An excisional biopsy can be used for tissue diagnosis in cases of diagnostic uncertainty. Case presentation The authors report a case of cavernous hemangioma of the breast in a 15-year-old adolescent female complaining of a rapidly enlarging firm and mobile lump in the right breast. Breast ultrasonography revealed a well-circumscribed, encapsulated, heteroechoic mass with smooth margins in the retroareolar region of the right breast. Subsequent excision of the lump revealed features of a cavernous hemangioma, and the follow-up was uneventful. Discussion Cavernous hemangioma of the breast is a rare entity, and its diagnosis poses a significant challenge for clinicians, as the lump may not be noticeable. The clinical diagnosis is challenging; therefore, imaging is required. Breast ultrasonography typically shows a hypoechoic lobulated mass with clear borders, although isoechoic and hyperechoic appearances are also possible. Breast mammography revealed a well-defined mass with areas of calcification. Surgical excision is often necessary when there is a discordance between imaging and histopathological findings, lesions greater than 2 cm, and atypical/malignant features. Conclusion Breast hemangiomas are rare benign tumors with nonspecific imaging features that require tissue sampling for diagnosis. Clinicians should be familiar with these characteristics to ensure proper management.
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Gautam R, Dixit R, Pradhan GS. Venous Malformation in the Breast: Imaging Features to Avoid Unnecessary Biopsies or Surgery. J Radiol Case Rep 2023; 17:1-8. [PMID: 37600844 PMCID: PMC10435260 DOI: 10.3941/jrcr.v17i5.4635] [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: 08/22/2023] Open
Abstract
Venous malformations are now categorised under the broad heading of slow flow vascular malformations. They comprise abnormally dilated venous channels that fail to involute. These may be superficial or deep in location. We describe two cases of venous malformation in breast. Both the patients presented with focal pain in one breast. On mammography, they appeared as equal density well circumscribed soft tissue masses. No sonographic correlate was found on initial ultrasound examination. Subsequent ultrasonography performed by an experienced radiologist with minimal probe pressure revealed dilated veins. On the basis of imaging findings, the diagnosis of venous malformation was established.
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Affiliation(s)
- Richa Gautam
- Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, G.I.P.M.E.R. and G.N.E.C. Hospitals, New Delhi, Delhi-110002 India
| | - Rashmi Dixit
- Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, G.I.P.M.E.R. and G.N.E.C. Hospitals, New Delhi, Delhi-110002 India
| | - Gaurav Shanker Pradhan
- Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, G.I.P.M.E.R. and G.N.E.C. Hospitals, New Delhi, Delhi-110002 India
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Shin J, Kapoor M, Patel M, Krishnamurthy S, Whitman GJ. Comparing Breast Hemangiomas to Breast Angiosarcomas: An Imaging Based Review. Curr Probl Diagn Radiol 2023; 52:212-219. [PMID: 36804401 DOI: 10.1067/j.cpradiol.2023.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Revised: 11/20/2022] [Accepted: 01/18/2023] [Indexed: 01/22/2023]
Abstract
Vascular tumors of the breast are rare, and most can be classified as either hemangiomas or angiosarcomas. Breast hemangiomas are benign vascular tumors that are often found incidentally at pathologic examination. Breast hemangiomas may mimic low grade angiosarcomas, which are malignant vascular tumors. This article illustrates the imaging characteristics of breast hemangiomas and breast angiosarcomas across multiple imaging modalities.
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Affiliation(s)
- Jane Shin
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston TX
| | - Megha Kapoor
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston TX
| | - Miral Patel
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston TX
| | - Savitri Krishnamurthy
- Department of Pathology, The University of Texas MD Anderson Cancer Center, Houston TX
| | - Gary J Whitman
- Department of Breast Imaging, The University of Texas MD Anderson Cancer Center, Houston TX
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Kim JH, Jung H, Cho YU. Giant mixed hemangioma of the breast: A case report with imaging findings. Radiol Case Rep 2023; 18:1710-1714. [PMID: 36895890 PMCID: PMC9989314 DOI: 10.1016/j.radcr.2023.02.008] [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: 12/16/2022] [Accepted: 02/03/2023] [Indexed: 03/03/2023] Open
Abstract
Hemangioma of the breast is an uncommon tumor type that is usually small, superficially located, and impalpable. The majority of cases are cavernous hemangiomas. We describe a rare case of a large, palpable mixed hemangioma of the breast which was located in the parenchymal layer, studied with magnetic resonance imaging, mammography, and sonography. Magnetic resonance imaging findings of slow and persistent enhancement from the center to periphery are useful in characterizing benign breast hemangiomas, where even the lesion presents with a suspicious shape and margin on sonography.
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Affiliation(s)
- Ji Hee Kim
- Department of Radiology, CHA Ilsan Medical Center, CHA University School of Medicine, 1205, Jungang-ro, Ilsandong-gu, Goyang, 10414, Republic of Korea
| | - Hera Jung
- Department of Pathology, CHA Ilsan Medical Center, CHA University School of Medicine, 1205, Jungang-ro, Ilsandong-gu, Goyang, 10414, Republic of Korea
| | - Young Up Cho
- Department of General Surgery, CHA Ilsan Medical Center, CHA University School of Medicine, 1205, Jungang-ro, Ilsandong-gu, Goyang, 10414, Republic of Korea
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6
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Azam R, Mrkonjic M, Gupta A, Gladdy R, Covelli AM. Mesenchymal Tumors of the Breast: Fibroblastic/Myofibroblastic Lesions and Other Lesions. Curr Oncol 2023; 30:4437-4482. [PMID: 37232796 DOI: 10.3390/curroncol30050338] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 04/05/2023] [Accepted: 04/08/2023] [Indexed: 05/27/2023] Open
Abstract
Mesenchymal breast tumors are a rare and diverse group of tumors that present some of the most challenging cases for multidisciplinary breast cancer teams. As a result of overlapping morphologies and a lack of large-scale studies on these tumors, practices are often heterogeneous and slow to evolve. Herein, we present a non-systematic review that focuses on progress, or lack thereof, in the field of mesenchymal breast tumors. We focus on tumors originating from fibroblastic/myofibroblastic cells and tumors originating from less common cellular origins (smooth muscle, neural tissue, adipose tissue, vascular tissue, etc.).
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Affiliation(s)
- Riordan Azam
- Postgraduate Medical Education, University of Toronto, Toronto, ON M5G 1V7, Canada
| | - Miralem Mrkonjic
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5G 1X5, Canada
- Mount Sinai Hospital and Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Abha Gupta
- Department of Medical Oncology, University of Toronto, Toronto, ON M5G 1X8, Canada
- The Hospital for Sick Children and Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 1X5, Canada
| | - Rebecca Gladdy
- Mount Sinai Hospital and Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2C4, Canada
- Division of Surgical Oncology, Department of Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada
| | - Andrea M Covelli
- Mount Sinai Hospital and Princess Margaret Cancer Center, University of Toronto, Toronto, ON M5G 2C4, Canada
- Division of Surgical Oncology, Department of Surgery, University of Toronto, Toronto, ON M5G 1X5, Canada
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7
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Sharma S, Nwachukwu C, Wieseler C, Elsherif S, Letter H, Sharma S. MRI Virtual Biopsy of T2 Hyperintense Breast Lesions. J Clin Imaging Sci 2021; 11:18. [PMID: 33880243 PMCID: PMC8053438 DOI: 10.25259/jcis_42_2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/22/2021] [Indexed: 01/15/2023] Open
Abstract
A wide variety of benign and malignant breast processes may generate hyperintense signal at T2-weighted magnetic resonance imaging (MRI). MRI has been traditionally used in the pre-treatment planning of breast cancer, in assessing treatment response and detecting recurrence. In this comprehensive review, we describe and illustrate the MRI features of a few common and uncommon T2 hyperintense breast lesions, with an emphasis on MRI features that help to characterize lesions based on morphological features, specific appearances on T1-and T2-weighted imaging, and enhancement characteristics on the dynamic post-contrast phase that are either diagnostic or aid in narrowing the differential diagnosis.
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Affiliation(s)
- Swati Sharma
- Department of Radiology, University of Florida, Jacksonville, Florida, United States
| | - Chidi Nwachukwu
- Department of Radiology, University of Florida, Jacksonville, Florida, United States
| | - Carissa Wieseler
- Department of Radiology, University of Florida, Jacksonville, Florida, United States
| | - Sherif Elsherif
- Department of Radiology, University of Florida, Jacksonville, Florida, United States
| | - Haley Letter
- Department of Radiology, University of Florida, Jacksonville, Florida, United States
| | - Smita Sharma
- Department of Radiology, University of Florida, Jacksonville, Florida, United States
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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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Singh BK, Ramana AP, Chumber S, Rathore YS, Sarangi J. Breast Hemangioma Manifesting as Breast Lump in an Elderly Female: a Case Report. Indian J Surg 2020. [DOI: 10.1007/s12262-020-02464-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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10
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Dugan M, Crandall M, Letter H, Jasra B. Intramuscular Cavernous Hemangioma of the Breast. Am Surg 2019. [DOI: 10.1177/000313481908500720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Marie Crandall
- Department of Surgery University of Florida College of Medicine Jacksonville, Florida
| | - Haley Letter
- Department of Radiology University of Florida College of Medicine Jacksonville, Florida
| | - Bharti Jasra
- Department of Surgery University of Florida College of Medicine Jacksonville, Florida
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11
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Isaza Zapata S, Uribe González R, González Vasquez CM. Breast hemangioma in a male patient: Report of a case. Radiol Case Rep 2019; 14:427-429. [PMID: 30701010 PMCID: PMC6348300 DOI: 10.1016/j.radcr.2019.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 01/05/2019] [Accepted: 01/06/2019] [Indexed: 11/29/2022] Open
Abstract
Breast hemangioma is a rare benign tumor in female and extremely rare in males. They are part of vascular tumors. Here, we described the case of a male patient who had a breast hemangioma for 30 years that was diagnosed incidentally in a thorax and abdomen tomography. We briefly review epidemiology, histopathology, clinical, and imaging findings related to breast hemangioma.
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Affiliation(s)
| | | | - Carlos Mario González Vasquez
- General Radiologist at CediMed and Hospital Pablo Tobón Uribe, Radiology Professor at Universidad CES and Universidad Pontificia Bolivariana, Medellín, Colombia
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