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Ma X, Chen X, Jiang G, Jiang L, Li T, Wei L, Li S. Metastatic embryonal rhabdomyosarcoma of the breast: A case report and literature review. Breast J 2021; 27:890-894. [PMID: 34672049 DOI: 10.1111/tbj.14284] [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: 05/20/2021] [Revised: 08/01/2021] [Accepted: 08/04/2021] [Indexed: 11/29/2022]
Abstract
Rhabdomyosarcoma (RMS) is a common malignancy in children, but embryonal rhabdomyosarcoma (ERMS) deposits rarely occur in the breast in adults. Therefore, little is known about magnetic resonance imaging (MRI) features of breast metastases from RMS, especially the embryonal type. We reported a case of a 22-year-old woman who was diagnosed with ERMS at left foot 2 years ago and accepted operation and chemotherapy. She was confirmed to have breast metastases from the left foot. Successive imaging examinations were performed 3 months apart. Breast ultrasound indicated a benign lesion, and further examination did not reveal any bone metastases. However, predominant restricted diffusion and rim contrast enhancement on MRI combined with the patient's medical history suggested a malignancy of BI-RADS 5. After 3 months, breast ultrasound revealed masses detected last time became larger and lobulated. In addition, internal heterogeneous intensity and rim contrast enhancement with restricted diffusion were revealed on MRI. We speculated that typical MRI findings of breast metastases from RMS may include iso- to hypointensity on T1WI, heterogeneous hyperintensity on T2WI, and circular enhancement with restricted diffusion. Moreover, mild peritumoral edema, rapid expansion of necrosis, and ascending time-intensity curve detected on MRI may be features of the ERMS type.
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Affiliation(s)
- Xuejin Ma
- Department of Radiology, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Xiaoxi Chen
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Guoyuan Jiang
- Department of Breast Surgery, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Lin Jiang
- Department of Radiology, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Tingchao Li
- Department of Pathology, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Ling Wei
- Department of Radiology, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
| | - Shiguang Li
- Department of Radiology, The First People's Hospital of Zunyi, The Third Affiliated Hospital of Zunyi Medical University, Zunyi, China
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Abstract
OBJECTIVE Mesenchymal breast tumors originate from the various components of mammary stroma. The aim of this review is to discuss the clinical presentation, imaging appearance, and management of mesenchymal breast lesions. CONCLUSION Although many mesenchymal tumors exhibit characteristic findings on imaging, others show nonspecific characteristics and require tissue biopsy for diagnosis. An awareness of the clinical and imaging presentation is essential in guiding the differential diagnosis and patient management.
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Bayramoglu Z, Kebudi R, Yilmaz R, Buyukkapu Bay S, Kebudi A, Karanlik H, Iribas A, Darendeliler E, Onder S, Bilgic B, Adaletli I. Primary Rhabdomyosarcoma of the Breast: Imaging Findings and Literature Review. Breast Care (Basel) 2018; 13:293-297. [PMID: 30319332 DOI: 10.1159/000487750] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Background Primary breast rhabdomyosarcoma (RMS) can occur in children. There is a lack of knowledge regarding radiologic findings and added diffusion-weighted magnetic resonance imaging (MRI) features of RMS in the literature. Case Report A 12-year-old girl was diagnosed with primary alveolar RMS of the breast. Gray scale ultrasound revealed posterior acoustic enhancement behind a well-circumscribed, multilobulated hypoechoic mass. Doppler ultrasound revealed increased peripheral and central vascularity. Hypointense septations on T2-weighted image exhibiting more enhancement than the stroma on late gadolinium-enhanced images were striking within a hyperintense mass. A hyperintense hemorrhagic focus on T1-weighted image was present in the absence of any necrosis. Avid enhancement on early postcontrast images proceeding from the periphery to the center was depicted. Conclusion A rapidly enlarging mass with an echogenic peripheral rim together with posterior acoustic enhancement on gray scale ultrasound, intense vascularity on Doppler ultrasound, axillary lymphadenopathy, and satellite nodules on MRI should raise suspicion. Enhancing central and peripheral septations are suggestive of RMS. Dynamic contrast-enhanced MRI in suspected cases can provide valuable data in the differential diagnosis.
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Affiliation(s)
- Zuhal Bayramoglu
- Pediatric Radiology Division, Radiology Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Rejin Kebudi
- Pediatric Hematology-Oncology Section, Cerrahpasa Medical Faculty, Istanbul University, Istanbul, Turkey.,Pediatric Hematology-Oncology Department, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Ravza Yilmaz
- Radiology Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Sema Buyukkapu Bay
- Pediatric Hematology-Oncology Department, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Abut Kebudi
- Department of Surgery and Surgical Oncology, School of Medicine, Maltepe University, Istanbul, Turkey
| | - Hasan Karanlik
- Department of Surgery, Istanbul University Oncology Institute, Istanbul, Turkey
| | - Ayca Iribas
- Department of Radiation Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Emin Darendeliler
- Department of Radiation Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Semen Onder
- Pathology Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Bilge Bilgic
- Pathology Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
| | - Ibrahim Adaletli
- Pediatric Radiology Division, Radiology Department, Istanbul Medical Faculty, Istanbul University, Istanbul, Turkey
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Breast Metastases in Children and Adolescents With Rhabdomyosarcoma: A Large Single-Institution Experience and Literature Review. J Pediatr Hematol Oncol 2017; 39:67-71. [PMID: 27820124 DOI: 10.1097/mph.0000000000000680] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Breast metastasis is rare in childhood malignancies. Soft tissue sarcomas, especially rhabdomyosarcomas (RMS), and hematologic neoplasms, such as lymphomas, are the most common tumors that metastasize to the breast, albeit rare. MATERIALS AND METHODS All cases with breast metastasis within a cohort of 200 RMS patients followed in our institution during 1990 to 2014 were assessed retrospectively and the literature was reviewed. RESULTS There were 3 adolescent female patients with breast metastasis. All had alveolar histology. The primary tumors were in the parameningeal sites, extremities, and the perineum, respectively. Two patients had breast metastasis at diagnosis, and 1 during follow-up. In 1 breast lesion, there was a complete response to chemotherapy, and in another there was no response to chemotherapy, and the patient underwent radical mastectomy. In the third patient, there was partial response, and lesions progressed. All patients died with recurrent/progressive disease, 2 with no recurrence in the breast. In the English literature, there are 70 cases including our cases. All but 1 involve female patients, all adolescents, most have alveolar histology and poor prognosis. All had chemotherapy, whereas some had surgery and/or radiotherapy for local treatment. CONCLUSION Breast metastasis should be considered in adolescent female patients with RMS. Optimal management is not clear. Besides chemotherapy, mastectomy and radiotherapy should be considered on a case basis.
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Iniesta SL, Cereceda MT, Adams CS, Menor CE. Breast relapse after metastatic alveolar rhabdomyosarcoma: Is it an incurable entity? Indian J Med Paediatr Oncol 2016; 37:119-21. [PMID: 27168712 PMCID: PMC4854044 DOI: 10.4103/0971-5851.180139] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Metastatic breast disease is a very rare condition in children. Rhabdomyosarcoma (RMS) is the most common solid primary tumor in children, but only a few cases of breast metastases have been described. We present the case of a young female with a primary pelvic metastatic alveolar RMS, which metastasized to the breast twice and achieved prolonged complete remission with a multimodal approach.
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6
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Magnetic resonance imaging findings of intramammary metastases. Clin Imaging 2016; 40:361-4. [PMID: 27133668 DOI: 10.1016/j.clinimag.2015.12.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 11/11/2015] [Accepted: 12/01/2015] [Indexed: 11/22/2022]
Abstract
The purpose of this study was to identify magnetic resonance imaging (MRI) findings of intramammary metastases (IM). We identified 8 cases with IM, which were investigated by breast MRI (1.5T). In every case, the diagnosis of IM was proven histopathologically on breast biopsy specimens. Overall, 187 IM were identified. IM had inconsistent MRI features, which cannot be clearly classify as benign or malignant. IM should be taken into consideration in the differential diagnosis of breast lesions to avoid possible misinterpretations.
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Abstract
The mainstay of breast imaging in the adolescent is ultrasonography. There is occasionally a need for additional imaging, particularly with magnetic resonance imaging (MRI). Imaging of the adolescent breast differs substantially from the adult in both the imaging modalities utilized and the relative likelihood of pathologies encountered. The majority of lesions in the adolescent are benign, but the presence of a breast lesion may cause anxiety to patients and their families due to the wide awareness of breast malignancy in the adult population. It is important to be aware of the imaging modalities available to image the adolescent breast to prevent unnecessary radiation exposure while answering the clinical question. The current recommendations for adolescent diagnostic and screening breast imaging will be reviewed. Benign breast lesions such as fibroadenomas, fibrocystic change, pseudoangiomatous stromal hyperplasia, gynecomastia, and posttraumatic or infectious lesions with their associated imaging findings and management will be outlined. Additionally, review of breast malignancies that can affect adolescents will provide the reader with features to distinguish benign from malignant processes in the adolescent based on imaging findings and clinical presentation.
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Affiliation(s)
- Katie N Jones
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
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8
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Abstract
A new breast mass was identified in an adult woman undergoing treatment for a known ethmoid sinus alveolar rhabdomyosarcoma. Histopathological evaluation revealed alveolar rhabdomyosarcoma metastatic to the breast. Alveolar rhabdomyosarcoma, primarily described in adolescents and especially rare in adults, can uncommonly metastasize to the breast.
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9
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Kim SJ. Magnetic resonance imaging features of inflammatory breast metastasis from gastric signet-ring cell carcinoma. Clin Imaging 2012; 37:569-73. [PMID: 23068056 DOI: 10.1016/j.clinimag.2012.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2012] [Accepted: 09/04/2012] [Indexed: 11/17/2022]
Abstract
This report presents a rare case of inflammatory breast metastasis from gastric signet-ring cell carcinoma. The clinical and radiologic findings were similar to those of primary inflammatory carcinoma or acute mastitis. Further, ultrasonography showed diffuse skin thickening and a diffuse infiltrative hypoechoic lesion with marked posterior acoustic shadowing in the left breast. Similarly, magnetic resonance imaging showed diffuse skin thickening/enhancement and a diffuse non-mass-like enhancement in the left breast and to a lesser degree in the right breast.
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Affiliation(s)
- Suk Jung Kim
- Department of Radiology, Haeundae Paik Hospital, Inje University College of Medicine, 1435 Jwa-dong, Haeundae-gu, Busan 612-030, South Korea.
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10
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Omranipour R, Hadi MR. Breast metastasis from multiple primary rhabdomyosarcoma in upper extremity. Clin Pract 2012; 2:e25. [PMID: 24765424 PMCID: PMC3981328 DOI: 10.4081/cp.2012.e25] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2011] [Revised: 12/06/2011] [Accepted: 12/17/2011] [Indexed: 11/30/2022] Open
Abstract
We report a 16-year-old girl with a multiple primary rhabdomyosarcoma of right upper extremity who developed contralateral breast metastasis in her clinical course. She was diagnosed to have multiple primary rhab-domyosarcoma of the right upper extremity with lung metastasis one year prior to finding a mass in her left breast. The excisional biopsy of the breast mass confirmed metastatic rhabdomyosarcoma. Despite aggressive chemotherapy and subcutaneous total mastectomy, she developed a widespread bone and lung metastasis in few months and expired. Metastatic rhabdomyosarcoma of the breast is very rare but it should be considered in adolescent females with primary alveolar rhabdomyosarcoma, specially located on an extremity.
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Affiliation(s)
- Ramesh Omranipour
- Department of Surgical Oncology of Cancer Institute, Imam Hospital, Tehran, Iran
| | - Mohamad Reza Hadi
- Department of Surgical Oncology of Cancer Institute, Imam Hospital, Tehran, Iran
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11
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Surov A, Fiedler E, Holzhausen HJ, Ruschke K, Schmoll HJ, Spielmann RP. Metastases to the breast from non-mammary malignancies: primary tumors, prevalence, clinical signs, and radiological features. Acad Radiol 2011; 18:565-74. [PMID: 21393030 DOI: 10.1016/j.acra.2010.12.009] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2010] [Revised: 12/14/2010] [Accepted: 12/14/2010] [Indexed: 11/30/2022]
Abstract
RATIONALE AND OBJECTIVES Most secondary intramammary tumors occur as metastatic involvement from the contralateral breast. Breast metastases (BM) from nonmammary malignancies are very rare. The aims of this study were to estimate retrospectively the prevalence of BM from nonmammary malignancies and to describe their radiologic appearance. MATERIALS AND METHODS BM were identified in 51 patients, including 43 women and eight men with a median age of 61 years (range, 24-84 years). Computed tomography of the thoracic region identified 108 lesions in 38 patients. Mammography was available for 37 patients (54 lesions). Ultrasound evaluation was performed in 43 patients (71 lesions). In 24 patients (93 lesions), magnetic resonance imaging of the breast was done. Images were reviewed in consensus by two radiologists according to the Breast Imaging Reporting and Data System lexicon. RESULTS The prevalence of BM in several tumors ranged from 0.12% to 4.92%. On computed tomography, most metastases were round or oval in shape with marked or moderate enhancement. On mammography, solitary or multiple round or oval masses with circumscribed margins were the most common pattern of BM. Ten percent showed microcalcifications. On ultrasound, most BM were hypoechoic, oval or round in shape, with microlobulated or circumscribed margins, and posterior acoustic enhancement. Doppler imaging showed hypervascularity in 39% of BM. On magnetic resonance imaging, most lesions demonstrated marked homogenous contrast enhancement. Type 1 kinetic curve was seen in 18%, type 2 in 52%, and type 3 in 30%. CONCLUSIONS The radiologic features reported in this study should be taken into consideration in the differential diagnosis of breast lesions.
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Affiliation(s)
- Alexey Surov
- Department of Radiology, Martin-Luther-University Halle-Wittenberg, Germany.
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12
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Ahn SJ, Kim SK, Kim EK. Metastatic breast cancer from rhabdomyosarcoma mimicking normal breast parenchyma on sonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:489-492. [PMID: 20194946 DOI: 10.7863/jum.2010.29.3.489] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Affiliation(s)
- Sung Jun Ahn
- Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
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13
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Chung EM, Cube R, Hall GJ, González C, Stocker JT, Glassman LM. From the archives of the AFIP: breast masses in children and adolescents: radiologic-pathologic correlation. Radiographics 2009; 29:907-31. [PMID: 19448124 DOI: 10.1148/rg.293095010] [Citation(s) in RCA: 141] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
The spectrum of breast lesions in children and adolescents varies markedly from that for adults, with the former lesions being overwhelmingly benign. A breast mass in a young boy or girl may arise from normal and abnormal breast development. Other causes of masses include infection, trauma, and cyst formation. After onset of puberty, most cases of breast enlargement arise from benign fibroadenoma in girls and gynecomastia in boys. These conditions have specific imaging appearances, although juvenile (often giant) fibroadenoma cannot be distinguished from phyllodes tumor, which can be benign or malignant. In children, both conditions usually appear as well-circumscribed, hypoechoic masses at sonography and show diffuse enhancement except for nonenhancing septations at magnetic resonance imaging. A diagnosis of juvenile papillomatosis (a benign lesion) portends later development of breast cancer, and patients with this condition should be closely monitored. Malignant lesions of the breast in children are rare. The most common malignant lesions are metastases and are usually associated with widespread disease. The most common primary breast malignancy is malignant phyllodes tumor. Primary breast carcinoma is exceedingly rare in the pediatric age group, but its imaging appearance in children is the same as seen in adults and is different from that of almost all benign lesions. In girls, diagnostic interventions may injure the developing breast and cause subsequent disfigurement. Given this risk and the low prevalence of malignant disease in this population, a prudent course should be followed in the diagnosis of breast lesions. Imaging findings are very helpful for selecting patients for further diagnostic procedures. Although malignancy is rare, lesions with suspicious imaging findings or progressive growth should be subjected to cytologic or histologic examination.
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Affiliation(s)
- Ellen M Chung
- Department of Radiology, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA.
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14
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Noguera JJ, Martínez-Miravete P, Idoate F, Díaz L, Pina L, Zornoza G, Martínez-Regueira F. Metastases to the breast: a review of 33 cases. ACTA ACUST UNITED AC 2007; 51:133-8. [PMID: 17419856 DOI: 10.1111/j.1440-1673.2007.01681.x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The aim of the study was to show the clinical and radiological manifestations of metastases to the breast (MB). From 1987 to 2006, 33 patients with MB were diagnosed at our institution. Their clinical and radiological features were retrospectively evaluated. Of the 33 cases, 31 presented as a palpable breast lump. On mammography, their findings were classified as follows: well-circumscribed masses (11 cases), ill-circumscribed masses (five), focal asymmetric densities (one) and inflammatory skin changes (six). Mammograms were normal in six cases (all of them showed dense breast tissue). Four CT scans showed two well-circumscribed masses and two ill-circumscribed masses. Ultrasonography was available in 18 cases: hypoechoic lesions (15 cases) were more frequent than hyperechoic (one) or isoechoic lesions (two). The appearance on magnetic resonance was similar to primary breast cancer (one case). The most common primary tumours causing MB were haematological malignancies (nine cases) and melanomas (seven). Metastases to the breast showed a wide range of mammographic and ultrasonographic appearances, resembling both benign and malignant lesions. Any patient who presents with a breast lump with a history of cancer should undergo a core-needle biopsy in order to determine the histology of the lump.
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Affiliation(s)
- J J Noguera
- Department of Radiology, University Clinic, University of Navarra, Spain
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15
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Charfi S, Ayadi L, Khanfir A, Ben Mahfoudh K, Khabir A, Bahri I, Gouiaa N, Makni S, Mnif Z, Frikha M, Sellami-Boudawara T. Métastase mammaire d’un choriocarcinome. IMAGERIE DE LA FEMME 2007. [DOI: 10.1016/s1776-9817(07)88743-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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16
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Dausse F, Balu-Maestro C, Chapellier C, Leblanc-Talent P. Rhabdomyosarcoma of the breast. Clin Imaging 2006; 29:337-41. [PMID: 16153540 DOI: 10.1016/j.clinimag.2005.01.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2004] [Revised: 01/02/2005] [Accepted: 01/24/2005] [Indexed: 10/25/2022]
Abstract
AIM The aim of this study was to describe the first imaging studies of a primary embryonal rhabdomyosarcoma of the breast in an adult woman. PATIENT This 45-year-old woman was seen for investigation of a palpable mass in the left breast. Examinations included mammography, Doppler ultrasound, and MRI. The diagnosis was made after surgical biopsy. Treatment consisted in neoadjuvant chemotherapy, followed by quadrantectomy and interstitial curietherapy. Imaging studies were performed both prior to and during therapy (i.e., after three then after six courses of chemotherapy). Imaging findings were correlated with histopathological findings. RESULTS Mammography was not very contributive as the breasts were dense, particularly in the external left quadrants. On ultrasound, the mass had a tissue density and sharp contours; the mass was not highly vascularized on Doppler. MRI revealed a mass that enhanced markedly on both early and late contrast-enhanced T1-weighted sequences and was hyperintense on T2-weighted sequences. MRI appeared to be the best technique for the evaluation of the residual tissue. CONCLUSION Rhabdomyosarcoma is a rare tumor in adults; to our knowledge, this is the first report describing the imaging features and value of MRI for the work-up and follow-up of mammary rhabdomyosarcoma.
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Affiliation(s)
- Fabien Dausse
- Department of Radiology, Centre Antoine-Lacassagne, 33 Avenue de Valombrose, Nice Cedex 2 06189, France
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17
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Ashkar L, Mesurolle B, Tremblay F. Sonographic target sign and rim enhancement on magnetic resonance imaging in metastatic melanoma to the breast. ACTA ACUST UNITED AC 2006; 50:237-40. [PMID: 16732821 DOI: 10.1111/j.1440-1673.2006.01571.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
We report a target sign on ultrasound and peripheral rim enhancement on gadolinium (Gd)-enhanced MRI images in metastasis to the breast from melanoma. These classic signs, as reported in the liver (ultrasound target sign) and in primary breast cancers (Gd rim enhancement), are probably also of value in cases of metastatic lesions to the breast.
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Affiliation(s)
- L Ashkar
- Department of Radiology, Cedar Breast Clinic, McGill University Health Center, Royal Victoria Hospital, Montreal, Québec, Canada
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18
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Miller DV, Coffin CM, Zhou H. Rhabdomyosarcoma arising in the hand or foot: a clinicopathologic analysis. Pediatr Dev Pathol 2004; 7:361-9. [PMID: 15383931 DOI: 10.1007/s10024-003-6071-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2003] [Accepted: 02/04/2004] [Indexed: 10/26/2022]
Abstract
Rhabdomyosarcomas (RMS) arising at different anatomic sites have distinct clinicopathologic features that affect prognosis and outcome. RMS arising in the extremities generally have a worse prognosis. Case reports and anecdotal experience suggests the possibility that RMS of the hand or foot (RMSHF) may behave even more aggressively than RMS elsewhere in the extremities. This study describes clinicopathologic features and outcome of RMSHF. Charts and pathologic material from RMSHF cases from institutional files over a 32-year interval were reviewed. Additional cases from published reports and series over a 42-year interval were identified by a MEDLINE search. Pertinent clinicopathologic features for each case were compiled. Survival analysis and other data from these patients were compared with previously reported statistics in the literature for RMS at other anatomic sites, including elsewhere in the extremities. Six patients from the institutional files and 46 from published reports were identified. A number of adverse prognostic indicators were observed in the majority of these patients including alveolar morphology (86%) and distant metastasis at presentation (63%). Despite the aggressive nature of these tumors, the majority were smaller than 5 cm (61%). A propensity was observed for metastases to unusual sites such as breast, ovary, testis, pancreas, and kidney. The median survival was 19 months, and the 5-year survival was 27%. While these may reflect a constellation of findings related to site, it is also possible that alveolar histology is the main influence. RMSHF can present as a very small primary tumor with clinically evident or occult metastatic disease. Whether this reflects the location, the predominantly alveolar histologic type, or a molecular genetic subtype will require further analysis. Patients presenting with RMSHF should be thoroughly evaluated for occult metastases at the time of diagnosis and followed closely throughout treatment for subsequent involvement of unusual sites.
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Affiliation(s)
- Dylan V Miller
- Division of Anatomic Pathology, Department of Pathology and Laboratory Medicine, Mayo Clinic, Rochester, MN 55905, USA
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19
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Binokay F, Soyupak SK, Inal M, Celiktas M, Akgül E, Aksungur E. Primary and metastatic rhabdomyosarcoma in the breast: report of two pediatric cases. Eur J Radiol 2004; 48:282-4. [PMID: 14652147 DOI: 10.1016/s0720-048x(03)00041-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Rhabdomyosarcoma (RMS) is a common childhood malignancy which can rarely be located in the breast. Here, we report two pediatric cases of breast RMS, one primary, the other secondary involvement. Primary one is alveolar, and the other embryonal subtype. Imaging findings with ultrasonography (US), computed tomography (CT) and magnetic resonance imaging (MRI) and a thorough review of literature are presented.
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Affiliation(s)
- F Binokay
- Department of Radiology, Faculty of Medicine, Cukurova University, Balcali Adana 01330, Turkey.
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20
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Jakovljevic B, Stevanovic O, BacIc G. Metastases to the Breast from Small-Cell Lung Cancer: Mr Findings. A case report. Acta Radiol 2003. [DOI: 10.1034/j.1600-0455.2003.00114.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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21
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Bartella L, Kaye J, Perry NM, Malhotra A, Evans D, Ryan D, Wells C, Vinnicombe SJ. Metastases to the breast revisited: radiological-histopathological correlation. Clin Radiol 2003; 58:524-31. [PMID: 12834635 DOI: 10.1016/s0009-9260(03)00068-0] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Metastases to the breast from extramammary tumours are infrequent. The main challenge in diagnosis is differentiating them from primary breast cancer. Radiologically this can be difficult as there are no specific imaging characteristics for metastases to the breast. Cytopathological evaluation, as well as full radiological assessment, is vital to avoid unnecessary surgery. Sources of primary tumours include a wide variety of cancers. In this pictorial review we illustrate a number of the commonest sources of primary tumours including lymphoma, lung, ovarian and cervical carcinoma, intestinal carcinoid and rare cases of Ewing's sarcoma and malignant pigmented melanocytic schwannoma (low-grade malignant melanoma).
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Affiliation(s)
- L Bartella
- Breast Assessment Centre, St Bartholomew's Hospital, London, UK
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22
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23
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Abstract
The three major categories of nonmammary malignancies of the breast include primary and secondary lymphoreticular malignancy, primary and secondary sarcoma, and hematogenous metastasis. This article describes the imaging features of 35 nonmammary malignancies of the breast and axilla with histopathologic confirmation. These include primary and secondary breast lymphoma, primary axillary nodal lymphoma, metastatic acute lymphatic leukemia, metastatic plasmacytoma, granulocytic sarcoma, primary angiosarcoma, metastatic rhabdomyosarcoma, hematogenous metastasis from primary lung, ovarian, cervical, thyroid, and colonic carcinoma, malignant melanoma, carcinoma of the nasal cavity, and adenocarcinoma of unknown primary. Wherever possible, correlation between mammography and ultrasound, computed tomography (CT), and/or magnetic resonance (MR) imaging is made.
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MESH Headings
- Adenocarcinoma/diagnosis
- Adenocarcinoma/diagnostic imaging
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Breast Neoplasms/diagnosis
- Breast Neoplasms/diagnostic imaging
- Breast Neoplasms/secondary
- Breast Neoplasms, Male/diagnosis
- Breast Neoplasms, Male/diagnostic imaging
- Female
- Hemangiosarcoma/diagnosis
- Hemangiosarcoma/diagnostic imaging
- Humans
- Leukemia/diagnosis
- Leukemia/diagnostic imaging
- Leukemia, Lymphoid/diagnosis
- Leukemia, Lymphoid/diagnostic imaging
- Leukemia, Myeloid/diagnosis
- Leukemia, Myeloid/diagnostic imaging
- Lymphoma/diagnosis
- Lymphoma/diagnostic imaging
- Magnetic Resonance Imaging
- Male
- Mammography
- Melanoma/diagnosis
- Melanoma/diagnostic imaging
- Middle Aged
- Plasmacytoma/diagnosis
- Plasmacytoma/diagnostic imaging
- Rhabdomyosarcoma/diagnosis
- Rhabdomyosarcoma/diagnostic imaging
- Sarcoma/diagnosis
- Sarcoma/diagnostic imaging
- Tomography, X-Ray Computed
- Ultrasonography, Doppler, Color
- Ultrasonography, Mammary
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Affiliation(s)
- W T Yang
- Department of Diagnostic Radiology & Organ Imaging, Chinese University of Hong Kong.
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