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Myoid hamartoma of the breast with focal chondromyoxid metaplasia and pseudoangiomatous stromal hyperplasia: A case report.

Su CC, Chen CJ, Kuo SJ, Chen DR - Oncol Lett (2015)

Bottom Line: The mass was histopathologically diagnosed as MHB with focal chondromyoxid metaplasia and pseudoangiomatous stromal hyperplasia.The histological diagnosis was based upon the findings of the well-circumscribed tumor, which was composed of entrapped mammary ducts, fat cells and myoid stromal components, with focal chondromyxoid metaplasia and pseudoangiomatous stromal hyperplasia.The tumor cells exhibited diffuse cluster of differentiation 34-positive immunoreactivity, which was consistent with a diagnosis of pseudoangiomatous stromal hyperplasia.

View Article: PubMed Central - PubMed

Affiliation: Tumor Research Center of Integrative Medicine, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; Department of Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, R.O.C.

ABSTRACT

Hamartomas of the breast, also known as fibroadenolipomas, lipofibroadenomas or adenolipomas, are benign lesions. Hamartomas account for between 0.04 and 1.15% of all benign breast tumors in females. Myoid hamartoma of the breast (MHB) is extremely rare. The present study describes a case of MHB in a 44-year-old female. Screening mammography revealed a lobulated partial indistinct isodense mass measuring ~3.8 cm in the upper outer quadrant of the left breast. Sonographic examinations revealed a 2-3-cm mass in the left breast, which was fairly well circumbscribed and demonstrated complex scattered echogenic areas and isoechoic tissue. A core needle biopsy demonstrated fibrocystic changes, with small focal ductule aggregations. As malignancy could not be excluded, a partial mastectomy was performed using a circumareolar incision. The mass was histopathologically diagnosed as MHB with focal chondromyoxid metaplasia and pseudoangiomatous stromal hyperplasia. The histological diagnosis was based upon the findings of the well-circumscribed tumor, which was composed of entrapped mammary ducts, fat cells and myoid stromal components, with focal chondromyxoid metaplasia and pseudoangiomatous stromal hyperplasia. The tumor cells exhibited diffuse cluster of differentiation 34-positive immunoreactivity, which was consistent with a diagnosis of pseudoangiomatous stromal hyperplasia.

No MeSH data available.


Related in: MedlinePlus

Sonography revealing a 2–3-cm, well-encapsulated mass in the left breast with complex scattered echogenic areas measuring ~2.42×2.17×1.36 cm, which displaced the adjacent normal breast tissue and was consistent with a diagnosis of lipoma and internal inhomogeneity.
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f2-ol-09-04-1787: Sonography revealing a 2–3-cm, well-encapsulated mass in the left breast with complex scattered echogenic areas measuring ~2.42×2.17×1.36 cm, which displaced the adjacent normal breast tissue and was consistent with a diagnosis of lipoma and internal inhomogeneity.

Mentions: A 44-year-old female was admitted to the Changhua Christian Hospital, LuKang branch Hospital, Outpatient Department (Changhua, Taiwan) on March 12, 2014 with a mass in the left breast that had been apparent for four months. A physical examination revealed the presence of a mass measuring ~3 cm in diameter in the upper outer quadrant (UOQ) of the left breast. The presence of a contralateral mass or axillary lymphadenopathy was not evident. Mammographical examinations performed to rule out malignancy revealed a lobulated partial indistinct isodense mass measuring ~3.8 cm in the UOQ of the left breast (Fig. 1) and suggested that further evaluation and tissue examinations were necessary. Ultrasonography examinations revealed a ~2.42×2.17×1.36 cm mass in the left breast, which was fairly well-circumscribed and demonstrated complex scattered echogenic areas and isoechoic tissue, which was consistent with a diagnosis of lipoma (Fig. 2). Due to the presence of heterogeneous echo dense areas, an ultrasound-guided core needle biopsy was recommended for further assessment. The core needle biopsy revealed fibrocystic changes with small focal duct aggregations. Immunohistochemically, intact myoepithelial cells were identified using p63 staining. A diagnosis of focal adenosis was considered. As malignancy could not be excluded, an excisional biopsy was performed using a circumareolar incision. The excised specimen, which consisted of a tissue fragment measuring 5.5×3.4×2.5 cm, was fixed in formalin. Grossly, the tissue appeared tan-white in color and elastic. Upon dissection, a whitish nodule measuring 1.7×1.5 cm was identified. Microscopically, a well-circumscribed tumor measuring 1.9×1.8 cm was identified, which was primarily composed of fibrous stroma, spindle cells, abundant fat cells and scatted mammary ductolobular units in the center or periphery of the tumor. Pseudoangiomatous stromal hyperplasia was also evident in the tumor region. Immunostaining revealed that the spindle cells were p63(−), cluster of differentiation 34(+) and desmin(+). Focal microcalcification was also apparent inside the ducts and lobules. Consequently, a diagnosis of myoid hamartoma with focal chondromyxoid differentiation and pseudoangiomatous stromal hyperplasia was established (Figs. 3 and 4). The patient exhibited no post-operative complications during the Outpatient Department follow-up and no further treatment was necessary.


Myoid hamartoma of the breast with focal chondromyoxid metaplasia and pseudoangiomatous stromal hyperplasia: A case report.

Su CC, Chen CJ, Kuo SJ, Chen DR - Oncol Lett (2015)

Sonography revealing a 2–3-cm, well-encapsulated mass in the left breast with complex scattered echogenic areas measuring ~2.42×2.17×1.36 cm, which displaced the adjacent normal breast tissue and was consistent with a diagnosis of lipoma and internal inhomogeneity.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356416&req=5

f2-ol-09-04-1787: Sonography revealing a 2–3-cm, well-encapsulated mass in the left breast with complex scattered echogenic areas measuring ~2.42×2.17×1.36 cm, which displaced the adjacent normal breast tissue and was consistent with a diagnosis of lipoma and internal inhomogeneity.
Mentions: A 44-year-old female was admitted to the Changhua Christian Hospital, LuKang branch Hospital, Outpatient Department (Changhua, Taiwan) on March 12, 2014 with a mass in the left breast that had been apparent for four months. A physical examination revealed the presence of a mass measuring ~3 cm in diameter in the upper outer quadrant (UOQ) of the left breast. The presence of a contralateral mass or axillary lymphadenopathy was not evident. Mammographical examinations performed to rule out malignancy revealed a lobulated partial indistinct isodense mass measuring ~3.8 cm in the UOQ of the left breast (Fig. 1) and suggested that further evaluation and tissue examinations were necessary. Ultrasonography examinations revealed a ~2.42×2.17×1.36 cm mass in the left breast, which was fairly well-circumscribed and demonstrated complex scattered echogenic areas and isoechoic tissue, which was consistent with a diagnosis of lipoma (Fig. 2). Due to the presence of heterogeneous echo dense areas, an ultrasound-guided core needle biopsy was recommended for further assessment. The core needle biopsy revealed fibrocystic changes with small focal duct aggregations. Immunohistochemically, intact myoepithelial cells were identified using p63 staining. A diagnosis of focal adenosis was considered. As malignancy could not be excluded, an excisional biopsy was performed using a circumareolar incision. The excised specimen, which consisted of a tissue fragment measuring 5.5×3.4×2.5 cm, was fixed in formalin. Grossly, the tissue appeared tan-white in color and elastic. Upon dissection, a whitish nodule measuring 1.7×1.5 cm was identified. Microscopically, a well-circumscribed tumor measuring 1.9×1.8 cm was identified, which was primarily composed of fibrous stroma, spindle cells, abundant fat cells and scatted mammary ductolobular units in the center or periphery of the tumor. Pseudoangiomatous stromal hyperplasia was also evident in the tumor region. Immunostaining revealed that the spindle cells were p63(−), cluster of differentiation 34(+) and desmin(+). Focal microcalcification was also apparent inside the ducts and lobules. Consequently, a diagnosis of myoid hamartoma with focal chondromyxoid differentiation and pseudoangiomatous stromal hyperplasia was established (Figs. 3 and 4). The patient exhibited no post-operative complications during the Outpatient Department follow-up and no further treatment was necessary.

Bottom Line: The mass was histopathologically diagnosed as MHB with focal chondromyoxid metaplasia and pseudoangiomatous stromal hyperplasia.The histological diagnosis was based upon the findings of the well-circumscribed tumor, which was composed of entrapped mammary ducts, fat cells and myoid stromal components, with focal chondromyxoid metaplasia and pseudoangiomatous stromal hyperplasia.The tumor cells exhibited diffuse cluster of differentiation 34-positive immunoreactivity, which was consistent with a diagnosis of pseudoangiomatous stromal hyperplasia.

View Article: PubMed Central - PubMed

Affiliation: Tumor Research Center of Integrative Medicine, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; Department of Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, R.O.C.

ABSTRACT

Hamartomas of the breast, also known as fibroadenolipomas, lipofibroadenomas or adenolipomas, are benign lesions. Hamartomas account for between 0.04 and 1.15% of all benign breast tumors in females. Myoid hamartoma of the breast (MHB) is extremely rare. The present study describes a case of MHB in a 44-year-old female. Screening mammography revealed a lobulated partial indistinct isodense mass measuring ~3.8 cm in the upper outer quadrant of the left breast. Sonographic examinations revealed a 2-3-cm mass in the left breast, which was fairly well circumbscribed and demonstrated complex scattered echogenic areas and isoechoic tissue. A core needle biopsy demonstrated fibrocystic changes, with small focal ductule aggregations. As malignancy could not be excluded, a partial mastectomy was performed using a circumareolar incision. The mass was histopathologically diagnosed as MHB with focal chondromyoxid metaplasia and pseudoangiomatous stromal hyperplasia. The histological diagnosis was based upon the findings of the well-circumscribed tumor, which was composed of entrapped mammary ducts, fat cells and myoid stromal components, with focal chondromyxoid metaplasia and pseudoangiomatous stromal hyperplasia. The tumor cells exhibited diffuse cluster of differentiation 34-positive immunoreactivity, which was consistent with a diagnosis of pseudoangiomatous stromal hyperplasia.

No MeSH data available.


Related in: MedlinePlus