Intracystic papillary carcinoma of the male breast

A case of intracystic papillary carcinoma with a multilocular cyst of the breast in male

Intracystic papillary carcinoma of the breast in males is a very rare disease but has an excellent prognosis. We report the case of a 68-year-old man who had a right subareolar soft mass. Imaging examinations showed a multilocular cyst with an intracystic component, and benign disease was diagnosed. Fine needle aspiration of the cyst fluid revealed many malignant cells, and modified radical mastectomy was performed under general anesthesia. Histological examination showed intracystic papillary carcinoma with a multilocular cyst. No positive lymph nodes were involved. The diagnosis of intracystic papillary carcinoma of male breast should be made carefully to avoid misdiagnosing benign disease.

Intracystic papillary carcinoma of the breast in a male patient diagnosed by ultrasound-guided core biopsy: a case report

Male breast cancer is an uncommon disease with an incidence of approximately 1% of all breast cancers. We report a case of intracystic papillary carcinoma of the breast occurring in a 67-year-old man in whom the diagnosis was made by ultrasound-guided core biopsy. This report represents the first reported intracystic papillary carcinoma diagnosed by core biopsy and illustrates the cost-effectiveness of this technique in a male patient in providing diagnostic material and allowing for expeditious planning of definitive treatment.

Male breast disease: clinical, mammographic, and ultrasonographic features

PURPOSE

To describe and quantitate the radiological (mammographic and ultrasonographic) characteristics of male breast disease and to report the clinical and pathological findings.

MATERIALS AND METHODS

Two-hundred-thirty-six male patients with different male breast diseases, diagnosed at our institution between January 1990 and July 2001, were retrospectively evaluated. The history, physical examination, mammographic and ultrasonographic findings were analyzed.

RESULTS

The spectrum of the disease in 236 male patients were gynecomastia (n=206), primary breast carcinoma (n=14), fat necrosis (n=5), lipoma (n=3), subareolar abscess (n=2), epidermal inclusion cyst (n=1), sebaceous cyst (n=1), hematoma (n=1), myeloma (n=1), and metastatic carcinoma (n=2). The distribution of patterns of gynecomastia were; 34% (n=71) nodular, 35% (n=73) dendritic and 31% (n=62) diffuse glandular. Gynecomastia was unilateral in 55% (n=113) and bilateral in 45% (n=93) of the patients. Male breast cancer presented as a mass without microcalcifications in 86% (n=12) and with microcalcifications in 7% (n=1) of patients. The mass was obscured by gynecomastia, partially in two, totally in one patient. The location of the mass was retroareolar in 46% (n=6) and eccentric to the nipple in 54% (n=7) of patients. On ultrasonography (US), the contours were well-circumscribed in 20% (n=3) and irregular in 80% (n=12) of the masses.

CONCLUSION

Male breast has a wide spectrum of diseases, some of which have characteristic radiological appearances that can be correlated with their pathologic diagnosis. In the evaluation of the male breast, mammography and US are essential and should be performed along with physical examination.

Sonographic features of primary breast cancer in men

OBJECTIVE

The imaging studies of eight men with proven primary breast cancer and preoperative sonography and mammography were reviewed and correlated with final pathology reports.

CONCLUSION

There were five cases of invasive breast carcinoma and three cases of ductal carcinoma in situ of the papillary subtype. All three cases of papillary ductal carcinoma in situ showed cystic features on sonography. Most (4/5) invasive cancers were solid on sonography. The appearance of a complex cystic mass in the male breast on sonography should suggest the possibility of malignancy and therefore warrants biopsy.