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Solitary fibrous tumor of the male breast: a case report and review of the literature.

Rovera F, Imbriglio G, Limonta G, Marelli M, La Rosa S, Sessa F, Dionigi G, Boni L, Dionigi R - World J Surg Oncol (2008)

Bottom Line: In such cases the right preoperative diagnosis is often difficult and challenging, because both radiological and cytological examinations are not exhaustive.Although rare, this lesion opens difficulties in preoperative diagnosis entering in differential diagnosis with other benign lesions as well as with breast cancer.Problems related to differential diagnosis and the possible pitfalls that can be encountered in the diagnostic iter of such rare tumor are discussed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgical Sciences, Ospedale di Circolo, Varese, Italy. francesca.rovera@uninsubria.it

ABSTRACT
Extrapleural solitary fibrous tumors are very rare and occasionally they appear in extraserosal soft tissues or parenchymatous organs. In such cases the right preoperative diagnosis is often difficult and challenging, because both radiological and cytological examinations are not exhaustive. For these reasons, surgical excision is frequently the only way to reach the correct diagnosis and to achieve definitive treatment. A few cases of solitary fibrous tumors have been also described in the breast. Although rare, this lesion opens difficulties in preoperative diagnosis entering in differential diagnosis with other benign lesions as well as with breast cancer. In this article we describe a case of a solitary fibrous tumor of the breast in a 49-year-old man. Problems related to differential diagnosis and the possible pitfalls that can be encountered in the diagnostic iter of such rare tumor are discussed.

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Breast ultrasound showed in the right retroareolar region, a solid mass of 3 × 1 cm with homogeneous echostructure and well-defined margins.
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Figure 1: Breast ultrasound showed in the right retroareolar region, a solid mass of 3 × 1 cm with homogeneous echostructure and well-defined margins.

Mentions: A 49-year-old white man presented at Department of Surgical Sciences of the University of Insubria in January 2007 due to a palpable painless nodule of the right breast, that he occasionally detected 3 months before. The patient had a positive family history for breast cancer (his mother was affected at the age of 55 years). His personal and pathological anamnesis did not highlight any significant evidence. Physical examination showed a lump of about 3 cm in the retroareolar region of the right breast, with well-defined margins, tense elastic consistence on palpation, mobile without skin or nipple-areola complex alterations. No ipsilateral axillary nodes have been detected. Breast ultrasound and fine-needle aspiration were performed. Breast ultrasound showed in the right retroareolar region, a solid mass of 3 × 1 cm with homogeneous echostructure and well-defined margins (fig. 1). These clinical and radiological data were highly suggestive for fibroadenoma. In cytological specimens only benign duct cells were observed. A surgical treatment was planned, with both diagnostic and therapeutic goals. The patient underwent surgical resection of the lesion in March 2007. Macroscopically, tumor presented as a white-grayish well demarcated unencapsulated nodule of 28 mm in diameter. Histologically, the lesion was composed of a proliferation of bland-looking cells admixed with thin collagen fibers. Cell appearance ranged from fibroblastic-like cells with elongated nuclei and scanty cytoplasm, to epitheliod-like oval cells with abundant eosinophilic cytoplasm and round to oval, centrally located, nuclei. No mitoses were found as well as areas of necrosis or hemorrhage. Immunohistochemical stains, performed using the avidin-biotin complex procedures, showed immunoreactivity for vimentin and CD34, while cells were completely negative for S100-protein, α-smooth muscle actin, desmin, cytoheratin AE1/AE3, and neurofilaments (fig. 2 A,B,C). On the basis of these morphological and immunohistochemical findings the diagnosis of solitary fibrous tumor was made.


Solitary fibrous tumor of the male breast: a case report and review of the literature.

Rovera F, Imbriglio G, Limonta G, Marelli M, La Rosa S, Sessa F, Dionigi G, Boni L, Dionigi R - World J Surg Oncol (2008)

Breast ultrasound showed in the right retroareolar region, a solid mass of 3 × 1 cm with homogeneous echostructure and well-defined margins.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2266749&req=5

Figure 1: Breast ultrasound showed in the right retroareolar region, a solid mass of 3 × 1 cm with homogeneous echostructure and well-defined margins.
Mentions: A 49-year-old white man presented at Department of Surgical Sciences of the University of Insubria in January 2007 due to a palpable painless nodule of the right breast, that he occasionally detected 3 months before. The patient had a positive family history for breast cancer (his mother was affected at the age of 55 years). His personal and pathological anamnesis did not highlight any significant evidence. Physical examination showed a lump of about 3 cm in the retroareolar region of the right breast, with well-defined margins, tense elastic consistence on palpation, mobile without skin or nipple-areola complex alterations. No ipsilateral axillary nodes have been detected. Breast ultrasound and fine-needle aspiration were performed. Breast ultrasound showed in the right retroareolar region, a solid mass of 3 × 1 cm with homogeneous echostructure and well-defined margins (fig. 1). These clinical and radiological data were highly suggestive for fibroadenoma. In cytological specimens only benign duct cells were observed. A surgical treatment was planned, with both diagnostic and therapeutic goals. The patient underwent surgical resection of the lesion in March 2007. Macroscopically, tumor presented as a white-grayish well demarcated unencapsulated nodule of 28 mm in diameter. Histologically, the lesion was composed of a proliferation of bland-looking cells admixed with thin collagen fibers. Cell appearance ranged from fibroblastic-like cells with elongated nuclei and scanty cytoplasm, to epitheliod-like oval cells with abundant eosinophilic cytoplasm and round to oval, centrally located, nuclei. No mitoses were found as well as areas of necrosis or hemorrhage. Immunohistochemical stains, performed using the avidin-biotin complex procedures, showed immunoreactivity for vimentin and CD34, while cells were completely negative for S100-protein, α-smooth muscle actin, desmin, cytoheratin AE1/AE3, and neurofilaments (fig. 2 A,B,C). On the basis of these morphological and immunohistochemical findings the diagnosis of solitary fibrous tumor was made.

Bottom Line: In such cases the right preoperative diagnosis is often difficult and challenging, because both radiological and cytological examinations are not exhaustive.Although rare, this lesion opens difficulties in preoperative diagnosis entering in differential diagnosis with other benign lesions as well as with breast cancer.Problems related to differential diagnosis and the possible pitfalls that can be encountered in the diagnostic iter of such rare tumor are discussed.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Surgical Sciences, Ospedale di Circolo, Varese, Italy. francesca.rovera@uninsubria.it

ABSTRACT
Extrapleural solitary fibrous tumors are very rare and occasionally they appear in extraserosal soft tissues or parenchymatous organs. In such cases the right preoperative diagnosis is often difficult and challenging, because both radiological and cytological examinations are not exhaustive. For these reasons, surgical excision is frequently the only way to reach the correct diagnosis and to achieve definitive treatment. A few cases of solitary fibrous tumors have been also described in the breast. Although rare, this lesion opens difficulties in preoperative diagnosis entering in differential diagnosis with other benign lesions as well as with breast cancer. In this article we describe a case of a solitary fibrous tumor of the breast in a 49-year-old man. Problems related to differential diagnosis and the possible pitfalls that can be encountered in the diagnostic iter of such rare tumor are discussed.

Show MeSH
Related in: MedlinePlus