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Istefan E, Zimmerman M, Dahlin LB, Nyman E. Benign nerve tumours in the upper limb: a registry-based study of symptoms and surgical outcome. Sci Rep 2023; 13:11500. [PMID: 37460574 DOI: 10.1038/s41598-023-38184-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Accepted: 07/04/2023] [Indexed: 07/20/2023] Open
Abstract
Surgery for benign nerve tumours is performed for pathoanatomical diagnosis and symptomatic relief, but might cause residual problems. We aimed to assess patient-reported symptoms and disability before and after surgery at a national level. In total, 206 cases surgically treated for a benign peripheral nerve tumour 2010-2019 registered in the Swedish Quality Registry for Hand Surgery (HAKIR; response rates 22-34%) were analysed. Surgery reduced overall disability in the affected limb (QuickDASH 18/100 [IQR 5-36] preoperatively and 5/100 [IQR 0-22] 12 months postoperatively), improved ability to perform daily activities (HQ-8; 11/100 [IQR 0-50] preoperatively and 0/100 [IQR 0-20] 12 months postoperatively) and decreased three evaluated pain modalities: pain at rest (HQ-8; 20/100 [IQR 0-40] preoperatively and 0/100 [IQR 0-10] 12 months postoperatively), pain on motion without load (HQ-8; 20/100 [IQR 0-40] preoperatively and 0/100 [IQR 0-10] 12 months postoperatively), and pain on load (HQ-8; 24/100 [IQR 1-69] preoperatively and 1/100 [IQR 0-30] 12 months postoperatively). Cold sensitivity was a minor problem both before and after surgery (HQ-8; 0/100 [IQR 0-30] preoperatively and 1/100 [IQR 0-40] 12 months postoperatively). We conclude that surgery for benign peripheral nerve tumours provides good symptomatic relief with low risk for residual problems.
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Affiliation(s)
- Emanuel Istefan
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
| | - Malin Zimmerman
- Department of Orthopaedics, Helsingborg Hospital, Helsingborg, Sweden
- Department of Translational Medicine - Hand Surgery, Lund University, Malmö, Sweden
| | - Lars B Dahlin
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
- Department of Translational Medicine - Hand Surgery, Lund University, Malmö, Sweden
- Department of Hand Surgery, Skåne University Hospital, Malmö, Sweden
| | - Erika Nyman
- Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden.
- Department of Hand Surgery, Plastic Surgery and Burns, Department of Biomedical and Clinical Sciences, Linköping University Hospital, 581 83, Linköping, Sweden.
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Jung HK, Lim YJ. Sonographic Features of Palpable Breast and Axillary Lesions in Adult Male Patients: A Pictorial Essay. JOURNAL OF THE KOREAN SOCIETY OF RADIOLOGY 2022; 83:830-845. [PMID: 36238906 PMCID: PMC9514573 DOI: 10.3348/jksr.2021.0122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/28/2021] [Accepted: 10/15/2021] [Indexed: 11/15/2022]
Abstract
The male breast is a non-functional and rudimentary organ, but similarly to the female breast, it can be affected by various diseases. In contrast to female breast cancer, male breast cancer has a low incidence, and there is no established breast cancer screening program for male patients. Therefore, the diagnostic evaluation is usually performed in male patients with symptoms such as palpability or pain in the breasts. Furthermore, most adult male patients who visit breast clinics sometimes present with not only breast symptoms but also axillary symptoms, and both the breast and axilla are usually examined during breast ultrasonography in daily clinical practice. The purpose of this pictorial essay was to present the sonographic features of various palpable breast and axillary lesions in adult male patients.
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Ryu KH, Moon JI, Baek HJ, Cho SB, Choi BH, An HJ, Song DH. Brachial plexus schwannoma mimicking cervical lymphadenopathy: A case report with emphasis on imaging features. Medicine (Baltimore) 2018; 97:e12880. [PMID: 30335008 PMCID: PMC6211920 DOI: 10.1097/md.0000000000012880] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
RATIONALE Brachial plexus schwannomas are rare benign tumors that are derived from Schwann cells. Because they are rare, and because of the complexity of the anatomy of the neck, these tumors can be a challenge to diagnose for radiologists and clinicians. In the present study, we describe a clinical case of brachial plexus schwannoma detected on ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), and presenting as a palpable neck mass. PATIENT CONCERNS A 49-year-old woman had a palpable mass in the right neck, which had been there for the last 1 year. Metastatic cervical lymphadenopathy was suspected in the primary health clinic; therefore, the patient was referred to our hospital. DIAGNOSES The right neck mass was a well-circumscribed oval soft tissue mass on US, CT, and MRI. US-guided core needle biopsy was performed and the mass was proved to be a schwannoma. INTERVENTIONS The patient did not undergo surgical excision because the brachial plexus schwannoma was small and there was no accompanying neurological symptom. OUTCOMES The patient is being followed up regularly at the outpatient department. LESSONS Brachial plexus schwannoma should be considered for a differential diagnosis in patients with a palpable neck mass, and imaging studies play an important role in diagnosing the brachial plexus schwannoma.
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Affiliation(s)
- Kyeong Hwa Ryu
- Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon
| | - Jin Il Moon
- Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon
| | - Hye Jin Baek
- Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon
- Gyeongsang National University School of Medicine, Jinju
| | - Soo Buem Cho
- Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon
| | - Bo Hwa Choi
- Department of Radiology, Gyeongsang National University Changwon Hospital, Changwon
| | - Hyo Jung An
- Department of Pathology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
| | - Dae Hyun Song
- Gyeongsang National University School of Medicine, Jinju
- Department of Pathology, Gyeongsang National University Changwon Hospital, Changwon, Republic of Korea
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Tammam TF, Kamhawy GA. Ultrasound-guided regional blockade for lipoma excision: a new approach to an old technique. Acta Anaesthesiol Scand 2017; 61:1325-1333. [PMID: 28832894 DOI: 10.1111/aas.12964] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Revised: 05/28/2017] [Accepted: 07/29/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND Local anesthesia for lipoma excision can be feasible with anesthetic injection in the fascial plane between the lipoma and the surrounding soft tissues under real-time ultrasonography [ultrasound- guided lipoma plane (ULP) block]. The advantage of targeting a single anesthetic injection plane under ultrasound guidance may allow for technically easier block placement and long-term analgesic effects. METHODS Forty-eight patients were randomly assigned to receive ULP block, group A (n = 24) or traditional block, group B (n = 24). Primary outcome measure was the number of needle passes required to perform the blockade. The level of procedure pain and the time to first request of analgesia were assessed. RESULTS Median (interquartile range) needle passes required to complete the blockade was significantly less in the group A 1(1, 1) in comparison with the group B 3 (2.5, 3); P = 0.0001. Group A required fewer needle redirections 1.5 (1, 2) than group B 2 (2, 2.5); P = 0.001. Group A showed significantly less procedure-related pain 2 (2, 3) when compared with group B 4 (3, 4); P = 0.0001. The time to first rescue analgesic was significantly longer in group A (21.3 ± 4.7 h) in comparison with group B (4.4 ± 1.2 h); P = 0.001. CONCLUSION Ultrasound-guided lipoma plane blockade reduces the number of needle passes required to complete the block and provides less procedure pain and longer pain relief compared with the traditional block in patients undergoing lipoma excision.
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Affiliation(s)
- T. F. Tammam
- Department of Anesthesia and Intensive Care; Faculty of Medicine; Suez Canal University Hospital; Ismailia Egypt
| | - G. A. Kamhawy
- Department of Anesthesia and Intensive Care; Faculty of Medicine; Suez Canal University Hospital; Ismailia Egypt
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Oh SW, Lim HS, Lee JS, Moon SM, Park MH. Invasive Micropapillary Carcinoma in Axillary Ectopic Breast and Synchronous Ductal Carcinoma In Situ in the Contralateral Breast. J Breast Cancer 2017; 20:314-318. [PMID: 28970859 PMCID: PMC5620448 DOI: 10.4048/jbc.2017.20.3.314] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Accepted: 04/11/2017] [Indexed: 11/30/2022] Open
Abstract
The development of ectopic breast tissue is attributable to the failure of primitive mammary tissue to regress after the development of the mammary ridge, except at pectoral breast sites, and is most often evident in the axillae. Several benign and malignant breast diseases have been reported in ectopic axillary breast tissues. The most common cancerous pathology of ectopic breast tissue is invasive ductal carcinoma. Ectopic breast cancer presenting with simultaneous primary cancer of the pectoral breast is extremely rare. Herein, we report an invasive micropapillary carcinoma of an axillary ectopic breast, combined with a synchronous ductal carcinoma in situ in the contralateral pectoral breast of a 61-year-old woman.
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Affiliation(s)
- Seung Won Oh
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Hyo Soon Lim
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Ji Shin Lee
- Department of Pathology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Sung Min Moon
- Department of Radiology, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
| | - Min Ho Park
- Department of Surgery, Chonnam National University Hwasun Hospital, Chonnam National University Medical School, Hwasun, Korea
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Lim HS, Kim SJ, Baek JM, Kim JW, Shin SS, Seon HJ, Heo SH. Sonographic Findings of Accessory Breast Tissue in Axilla and Related Diseases. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2017; 36:1469-1478. [PMID: 28370098 DOI: 10.7863/ultra.16.06056] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Accepted: 09/23/2016] [Indexed: 06/07/2023]
Abstract
Accessory breast tissue results from failed regression of primitive mammary tissue and is most often located in the axilla. Accessory breast tissue itself is normal and should not be misdiagnosed as an abnormality. Both benign and malignant diseases that occur in the normal breast can also develop in accessory breast tissue in the axilla. In this pictorial essay, we show sonographic findings of normal accessory breast tissue in the axilla and various lesions that occur in accessory axillary breast tissue, along with other imaging findings and pathologic features.
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Affiliation(s)
- Hyo Soon Lim
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
| | - Shin Jung Kim
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
| | - Jang Mi Baek
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
| | - Jin Woong Kim
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
| | - Sang Soo Shin
- Department of Radiology, Chonnam National University Hospital, Gwangju, Korea
| | - Hyun Ju Seon
- Department of Radiology, Chosun University School of Medicine, Gwangju, Korea
| | - Suk Hee Heo
- Department of Radiology, Chonnam National University Hwasun Hospital, Hwasun-eup, Korea
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Dey A, Sinha RTK. Clinicopathological Correlation of Axillary Masses – Importance of Fine Needle Aspiration Cytology as a Diagnostic Modality. JOURNAL OF MEDICAL SCIENCES AND HEALTH 2017. [DOI: 10.46347/jmsh.2017.v03i01.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Oliff MC, Birdwell RL, Raza S, Giess CS. The Breast Imager's Approach to Nonmammary Masses at Breast and Axillary US: Imaging Technique, Clues to Origin, and Management. Radiographics 2016; 36:7-18. [PMID: 26761528 DOI: 10.1148/rg.2016150029] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Ultrasonography (US) of the breast and axilla is primarily used to evaluate a symptomatic patient or to further investigate findings identified with other imaging modalities. Breast imagers are generally familiar with US evaluation of level I, II, and III axillary lymph nodes in the diagnosis and staging of breast cancer. However, the axilla contains nonlymphatic tissue as well, including muscle, fat, and vascular and neurologic structures, and anatomically the breast lies on the chest wall. Therefore, lesions of nonmammary and non-lymph node origin in the axilla or chest wall are not infrequently encountered during US evaluation of the breast or axilla. In fact, such lesions may be the reason that the patient presents to the breast imaging department for evaluation. Understanding the anatomy of the chest wall and axilla and using a systematic US approach will help radiologists expedite accurate diagnosis, suggest optimal additional imaging, and streamline appropriate clinical referral. Key imaging features of nonmammary non-lymph node masses are highlighted, and case examples are provided to illustrate these features. Appropriate patient management is critical in these cases because referral to a breast surgeon may not be the best next step. Depending on institutional referral patterns, other subspecialty surgeons will be involved. Online supplemental material is available for this article.
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Affiliation(s)
- Matthew C Oliff
- From the Department of Radiology, Breast Imaging Section, Brigham and Women's Hospital and Harvard University, Boston, Mass
| | - Robyn L Birdwell
- From the Department of Radiology, Breast Imaging Section, Brigham and Women's Hospital and Harvard University, Boston, Mass
| | - Sughra Raza
- From the Department of Radiology, Breast Imaging Section, Brigham and Women's Hospital and Harvard University, Boston, Mass
| | - Catherine S Giess
- From the Department of Radiology, Breast Imaging Section, Brigham and Women's Hospital and Harvard University, Boston, Mass
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Abstract
INTRODUCTION Leiomyoma is a form of benign tumor originated in hypertrophy of the smooth muscles, which is most prevalent in the uterus and gastrointestinal tract. However, Leiomyoma originating from smooth muscle at the vessels lying on deep soft tissue is very rare. CASE REPORT Our case was a rare case of leiomyoma originating from the axillary region, which was initially diagnosed as a fibroadenoma on radiological examination. The mass was separated from surrounding tissues and totally resected. Pathologically, hematoxylin-eosin-stained biopsy tissue showed the typical findings of leiomyoma. Postoperative follow-up observation was done for 1 year, without any complications or recurrence. CONCLUSION Notably, a leiomyoma in the axillary region is difficult to differentiate from other benign or malignant tumors on preoperative radiological examinations such as ultrasonography or computed tomgraphy. Therefore, when an indefinite asymptomatic mass that is not lymphadenopathy or common benign tumor is identified in the axillary region, leiomyoma can be considered as one of the differential diagnoses.
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Affiliation(s)
| | | | | | | | - Hyun Ho Han
- Department of Plastic and Reconstructive Surgery, Incheon St. Mary's Hospital, college of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Correspondence: Hyun Ho Han, Department of Plastic and Reconstructive Surgery, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, 56 Dongsu-ro, Bupyong-gu, Incheon 21431, Republic of Korea (e-mail: )
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10
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Abstract
An ipsilateral axillary mass was detected on pre-operative ultrasound in a 79-year-old woman with newly diagnosed breast carcioma. The mass had sonographic features that were initially thought to represent a lymph node completely replaced by metastatic disease. Though ultrasound-guided axillary fine-needle aspiration was attempted, it could not be performed due to pain. At surgery, the mass was found to be a brachial plexus tumor.
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Luo J, Mao Y, Cai S, Shen X, Chen S, Xie L. Post-nephrectomy foreign-body granuloma in the retroperitoneum mimicking lymph node metastasis of renal cell cancer. Onco Targets Ther 2014; 7:2137-41. [PMID: 25429231 PMCID: PMC4242698 DOI: 10.2147/ott.s70705] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Recently, iatrogenic foreign-body granuloma has been increasingly reported. The asymptomatic presentation and confusing appearance of granuloma can lead to misdiagnosis of a secondary malignancy, especially for a patient with a corresponding past medical history. Sometimes, surgical treatment is unavoidable, and the diagnosis relies upon the pathologic result. Herein, we report an unusual case of a 43-year-old man who underwent a nephrectomy for renal cell carcinoma (clear cell type) 5 years ago. A secondary granuloma was identified behind the inferior vena cava in the retroperitoneum 6 months after the surgery, but the radiologists had failed to identify it throughout the 4 years of routine examination. Later on, the lesion was identified by positron emission tomography, which classified it as a highly 18F-fluorodeoxyglucose-avid lesion. Considering no visible foreign-bodies identified on images, the lesion was arguably diagnosed as a lymph node metastasis of renal cancer. Finally, it was confirmed as a foreign-body granuloma encasing surgical suture and adipose tissue by the pathological analysis.
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Affiliation(s)
- Jindan Luo
- Department of Urology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Yeqing Mao
- Department of Urology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Songliang Cai
- Department of Urology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Xiaoyong Shen
- Department of Radiology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Shanwen Chen
- Department of Urology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
| | - Liping Xie
- Department of Urology, The First Affiliated Hospital of College of Medicine, Zhejiang University, Zhejiang, People's Republic of China
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Bulakci M, Gocmez A, Demir AA, Salmaslioglu A, Tukenmez M, Yavuz E, Acunas G. Fibroadenomatosis involving bilateral breasts and axillary accessory breast tissues in a renal transplant recipient given cyclosporin A. JOURNAL OF CLINICAL ULTRASOUND : JCU 2014; 42:495-497. [PMID: 25131521 DOI: 10.1002/jcu.22220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 07/04/2014] [Accepted: 07/21/2014] [Indexed: 06/03/2023]
Abstract
We present the mammographic and sonographic findings in a case of fibroadenomatosis involving both breasts and axillae in a renal transplant patient after 16 years of treatment with cyclosporin A. Awareness of the fact that cyclosporin A may induce the formation of fibroadenomas, including in accessory breast tissue, is important for correct diagnosis and preventing unnecessary intervention.
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Affiliation(s)
- Mesut Bulakci
- Department of Radiology, Istanbul University, Istanbul Faculty of Medicine, 34390, Capa, Istanbul, Turkey
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Park SH, Jeong YM, Cho SH, Jung HK, Kim SJ, Ryu HS. Imaging findings of variable axillary mass and axillary lymphadenopathy. ULTRASOUND IN MEDICINE & BIOLOGY 2014; 40:1934-1948. [PMID: 24948395 DOI: 10.1016/j.ultrasmedbio.2014.02.019] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/27/2013] [Revised: 01/17/2014] [Accepted: 02/12/2014] [Indexed: 06/03/2023]
Abstract
The axilla is a triangular space that contains mesenchymal tissues such as fat, vessels, nerves and lymph nodes, from which various diseases can develop. This article describes axillary masses and axillary lymphadenopathies using imaging findings from techniques such as ultrasonography, mammography, computed tomography and magnetic resonance imaging. Awareness of the characteristic imaging findings of disease entities that cause axillary masses and various axillary lymphadenopathies will help in the accurate diagnosis of axillary lesions.
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Affiliation(s)
- Sung Hee Park
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea.
| | - Yu Mi Jeong
- Department of Radiology, Gachon University Gil Hospital, Incheon, Korea
| | - So Hyun Cho
- Department of Radiology, Gachon University Gil Hospital, Incheon, Korea
| | - Hyun Kyung Jung
- Department of Radiology, Inje University Haeundae Paik Hospital, Busan, Korea
| | - Soo Jin Kim
- Department of Radiology, Chung-Ang University Hospital, Seoul, Korea
| | - Han Suk Ryu
- Department of Pathology, Seoul National University Hospital, Seoul, Korea
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The ABCs of accessory breast tissue: basic information every radiologist should know. AJR Am J Roentgenol 2014; 202:1157-62. [PMID: 24758674 DOI: 10.2214/ajr.13.10930] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Accessory breast tissue, residual breast tissue persisting from embryologic development, is found in up to 6% of the population, most commonly in the axilla along the "milk line." CONCLUSION Radiologists should be able to recognize the imaging appearance of this normal variant on multiple modalities, while at the same time understanding that the same spectrum of pathologic processes that occur in normal breast tissue can occur in accessory breast tissue as well.
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Koo HS, Sohn YM, Park YK. Sonographic appearance of a neuroendocrine tumor arising in the axilla: case report and literature review. JOURNAL OF CLINICAL ULTRASOUND : JCU 2014; 42:30-32. [PMID: 23233415 DOI: 10.1002/jcu.22024] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 11/19/2012] [Indexed: 06/01/2023]
Abstract
Neuroendocrine tumors (NETs) are tumors that originate from neuroendocrine cells throughout the body. NETs are most commonly found in the appendix, followed by the rectum, ileum, lungs, and bronchi. NETs arising in soft tissues are rare. Here we describe the sonographic appearance of a NET in the axilla.
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Affiliation(s)
- Hye Soo Koo
- Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, Seoul, South Korea
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Park JE, Sohn YM, Kim EK. Sonographic findings of axillary masses: what can be imaged in this space? JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2013; 32:1261-1270. [PMID: 23804349 DOI: 10.7863/ultra.32.7.1261] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The diagnosis of axillary masses can be challenging because various tumors can develop in parts of the axilla other than lymph nodes, even though we frequently encounter axillary masses in daily practice. These lesions include soft tissue masses associated with nontumorous conditions (accessory breast tissue and chronic granulomatous inflammation) and benign and malignant tumorous conditions (lipomas, epidermal inclusion cysts, lymphangiomas, fibroadenomas, schwannomas, malignant neuroendocrine tumors, and lymph node-associated diseases). In this pictorial essay, we display commonly encountered sonographic findings of various axillary lesions to assist in the differential diagnosis of axillary masses.
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Affiliation(s)
- Ji Eun Park
- Department of Radiology, Kyung Hee University Hospital, College of Medicine, Kyung Hee University, 23 Kyungheedae-ro, Dongdaemun-gu, Seoul 130-872, Korea
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Abstract
OBJECTIVE This article reviews the imaging and histopathologic findings of various axillary diseases and suggests management guidelines for radiologists based on imaging findings with clinical correlation. CONCLUSION Although axillary diseases may reveal nonspecific imaging findings, a knowledge of the characteristic radiologic manifestations of specific diseases according to anatomic origin (nodal, accessory breast, adipocytic, fibrous, nerve, vascular, stromal, and dermal) and postsurgical lesions aids in establishing an appropriate differential diagnosis and determining whether intervention is necessary.
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Imaging features of superficial and deep fibromatoses in the adult population. Sarcoma 2012; 2012:215810. [PMID: 22966216 PMCID: PMC3395298 DOI: 10.1155/2012/215810] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2012] [Accepted: 03/30/2012] [Indexed: 12/13/2022] Open
Abstract
The fibromatoses are a group of benign fibroblastic proliferations that vary from benign to intermediate in biological behavior. This article will discuss imaging characteristics and patient demographics of the adult type superficial (fascial) and deep (musculoaponeurotic) fibromatoses. The imaging appearance of these lesions can be characteristic (particularly when using magnetic resonance imaging). Palmar fibromatosis demonstrates multiple nodular or band-like soft tissue masses arising from the proximal palmar aponeurosis and extending along the subcutaneous tissues of the finger in parallel to the flexor tendons. T1 and T2-weighted signal intensity can vary from low (higher collagen) to intermediate (higher cellularity), similar to the other fibromatoses. Plantar fibromatosis manifests as superficial lesions along the deep plantar aponeurosis, which typically blend with the adjacent plantar musculature. Linear tails of extension (“fascial tail sign”) along the aponeurosis are frequent. Extraabdominal and abdominal wall fibromatosis often appear as a heterogeneous lesion with low signal intensity bands on all pulse sequences and linear fascial extensions (“fascial tail” sign) with MR imaging. Mesenteric fibromatosis usually demonstrates a soft tissue density on CT with radiating strands projecting into the adjacent mesenteric fat. When imaging is combined with patient demographics, a diagnosis can frequently be obtained.
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Cotton-ball granuloma mimicking axillary lymphadenopathy in a breast cancer patient. Biomed Imaging Interv J 2012; 7:e19. [PMID: 22279496 PMCID: PMC3265191 DOI: 10.2349/biij.7.3.e19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2010] [Revised: 03/27/2011] [Accepted: 03/30/2011] [Indexed: 11/25/2022] Open
Abstract
Foreign body granuloma is a reaction to either a biodegradable substance or inert material. In a breast cancer patient who had undergone an excision or mastectomy with axillary clearance, a foreign body granuloma in the axilla may be misinterpreted as an axillary lymph node. We report our experience with a case of cotton-ball granuloma of the axilla in a breast cancer patient, which mimics a lymph node radiologically from the CT scan, mammogram and ultrasonography. Following biopsy and excision, the mass was diagnosed histologically as a foreign body granuloma.
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Sohn YM, Kim SY, Kim EK. Sonographic appearance of a schwannoma mimicking an axillary lymphadenopathy. JOURNAL OF CLINICAL ULTRASOUND : JCU 2011; 39:477-479. [PMID: 21538374 DOI: 10.1002/jcu.20826] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2010] [Accepted: 02/25/2011] [Indexed: 05/30/2023]
Abstract
Schwannomas are benign nerve sheath tumors derived from Schwann cells and are the most common type of peripheral nerve tumor. Schwannomas occur mainly in the extremities, trunk, and head and are rarely manifested in the axilla. Although various solid tumors can develop in the axilla, only a few cases of schwannoma in the axillary cavity have been reported. Herein, we describe the sonographic appearance of a schwannoma arising from the brachial plexus in the axilla.
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Affiliation(s)
- Yu-Mee Sohn
- Department of Radiology, Kyung Hee University Medical Center, College of Medicine, Kyung Hee University, Seoul, South Korea
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Extraskeletal chondroma: another diagnostic possibility for a soft tissue axillary mass in an adolescent. Case Rep Orthop 2011. [PMID: 23198206 PMCID: PMC3505889 DOI: 10.1155/2011/309328] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Extraskeletal chondroma is a benign cartilaginous tumor that occurs predominantly in the soft tissues near small joints of the hands and feet. There are rare reports of the lesion in other sites, such as the head, neck, trunk, oral cavity, larynx, and pharynx. We present a case of an axillary mass in a 15-year-old girl who underwent MRI examination and resection, with the ultimate diagnosis of an extraskeletal chondroma, in order to expand the differential diagnosis of an axillary soft tissue mass in an adolescent.
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Visconti G, Eltahir Y, Van Ginkel RJ, Bart J, Werker PMN. Approach and management of primary ectopic breast carcinoma in the axilla: where are we? A comprehensive historical literature review. J Plast Reconstr Aesthet Surg 2010; 64:e1-11. [PMID: 20934398 DOI: 10.1016/j.bjps.2010.08.015] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 06/29/2010] [Accepted: 08/12/2010] [Indexed: 12/28/2022]
Abstract
Primary ectopic breast carcinoma is a rare disease and, at present, no specific guidelines on its diagnosis and treatment are available. The purpose of this article is to review the world literature in English on primary ectopic breast carcinoma located in the armpit and to offer guidelines for diagnosis and treatment. Data for this review were identified by searches of MEDLINE, PubMed, The Cochrane Library, ACNP (Italian catalogue of journals) and references from relevant articles using relevant search terms and data published in the previous reviews. Primary ectopic breast carcinoma of the axilla mostly affects women of over 40 (range 28-90 yrs) years of age. The most frequent histological diagnosis is invasive ductal carcinoma not otherwise specified (NOS) (72%). Because of its rareness, in most cases, the diagnosis is delayed for on average 40.5 months. This disease is rare, but a high level of suspicion for carcinoma is mandatory when confronted with a tumour in this area. Once diagnosed, patients should undergo staging, and prognostic and adjuvant treatment procedures identical to orthotopic breast carcinoma guidelines. There are some limitations for the staging. Loco-regional treatment, on indication, combined with endocrine therapy and/or chemotherapy seems the treatment of choice.
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Affiliation(s)
- Giuseppe Visconti
- Department of Plastic and Reconstructive Surgery, Catholic University of Sacro Cuore-University Hospital A. Gemelli, Largo A. Gemelli 8, 00168 Rome, Italy.
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Sohn YM, Kim AH, Choi J, Kim EK, Moon HJ, Kim MJ, Park YN, Kwak JY. Giant cell tumor of a tendon sheath mimicking an axillary lymph node. JOURNAL OF CLINICAL ULTRASOUND : JCU 2010; 38:271-273. [PMID: 20091698 DOI: 10.1002/jcu.20661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
A giant cell tumor of the tendon sheath (GCTTS) is 1 of the most common soft-tissue tumors of the hand and wrist, while the 2nd most frequent site is the ankle-foot complex. Although various solid tumors can develop in the axilla, GCTTS has not yet been reported. We describe the sonographic appearance of GCTTS in the axilla.
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Affiliation(s)
- Yu-Mee Sohn
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea
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