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Phan VT, Nguyen NT, He J, Robinson AS, Nguyen QD. A Male Patient With Breast Hamartoma: An Uncommon Finding. Cureus 2020; 12:e9444. [PMID: 32864268 PMCID: PMC7451077 DOI: 10.7759/cureus.9444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Mammary hamartoma is a rare type of breast tumor that is composed of the same elements as normal mammary tissue. This condition is very rare in men. In current literature, there are fewer than five case reports on male breast hamartoma. This benign pathology is under-reported because of several reasons. Since breast tumors are still considered an exclusively female diagnosis and statistically proven to be gynecomastia when arising in men, they are often overlooked. In addition to the uncommon clinical presentation in men, insufficiency of definitive pathologic and radiologic characteristics can make an accurate diagnosis a challenging task. Mammary hamartoma is a benign condition with an excellent prognosis. The following case describes a rare instance of an enlarging mammary hamartoma in a male patient, highlighting the imaging features, pathohistological findings, and clinical management.
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Affiliation(s)
- Vincent T Phan
- Radiology, University of Texas Medical Branch, Galveston, USA
| | - Nga T Nguyen
- Radiology, University of Texas Medical Branch, Galveston, USA
| | - Jing He
- Pathology, University of Texas Medical Branch, Galveston, USA
| | | | - Quan D Nguyen
- Radiology, University of Texas Medical Branch, Galveston, USA
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Abstract
RATIONALE Mammary hamartoma is a rare benign breast tumor, composed of ducts, lobules, fibers, and adipose tissue. We describe a mammary hamartoma in a man; this is the fourth case being reported in the literature. PATIENT CONCERNS A 30-year-old man presented with a 1-month history of a painless mass in his right breast. DIAGNOSIS Ultrasound imaging and mammography revealed a lesion, approximately 2.0 cm × 2.0 cm in size, in the right breast, which was considered to be either a lipomyoma or an adenoma fibrosum. INTERVENTIONS The mass was surgically resected. Pathological examination confirmed the diagnosis of mammary hamartoma. OUTCOMES The patient was discharged from the hospital after surgery. There was no sign of reoccurrence during a 1-year follow-up period. LESSONS At present, mammary hamartoma is considered to be a benign lesion, usually treated by surgical resection. Some reports have suggested a possible association between a hamartoma and the development of breast malignancy. The pathology and biology of an association between a mammary hamartoma and malignancy have not been defined to date.
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Türkyılmaz Z, Aydın T, Yılmaz R, Önder S, Özkurt E, Tükenmez M, Müslümanoğlu M, Acunaş G, İğci A, Özmen V, Dinçağ A, Cabioğlu N. Our 20-Year Institutional Experience with Surgical Approach for Breast Hamartomas. Eur J Breast Health 2019; 15:171-175. [PMID: 31312793 DOI: 10.5152/ejbh.2019.4624] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Accepted: 03/06/2019] [Indexed: 11/22/2022]
Abstract
Objective Hamartomas are rare, slowly-growing breast tumours. Clinical, radiological and histopathological examination together increase the diagnostic accuracy. To evaluate the clinicopathologic features of hamartomas and outline our clinical approach to hamartomas in our 20-year experience at our Breast Clinic. Materials and Methods Between 1995 and 2015, 24 cases were retrospectively analyzed with a diagnosis of breast hamartoma at our Breast Clinic followed by excisional biopsy. Data was obtained on patient demographics, clinical examination, radiological findings and histopathological subtypes. Results Of 1338 benign breast tumours excised from January 1995 to January 2015, 24 (1.8%) were identified as breast hamartoma. Median age of patients was 42 (range, 13-70), whereas the median tumour size was 5 cm (1-10 cm). On preoperative imaging, hamartoma was most commonly misdiagnosed as fibroadenoma. Pathological examination of the 24 biopsy specimens revealed 3 cases with pseudoangiomatous stromal hyperplasia, and another hamartoma associated with a radial scar within the centre of the lesion. Of those, one patient was diagnosed with malignant phylloides tumour in the same breast. At a median follow-up 58.4 months, none of the patients recurred or developed malignancy. Conclusion Hamartomas can often be missed by clinicians, due to its benign nature which is poorly understood. Despite their slow growth, hamartomas can reach large sizes and can cause breast asymmetry. Although it is rare, hamartoma can be seen along with malignancy, as it is formed from similar components of breast tissue. Therefore, careful diagnosis and appropriate management including surgery are required.
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Affiliation(s)
- Zeliha Türkyılmaz
- Department of General Surgery, Trakya University School of Medicine, Edirne, Turkey
| | - Tahacan Aydın
- İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Ravza Yılmaz
- Department of Radiology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Semen Önder
- Department of Pathology, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Enver Özkurt
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Mustafa Tükenmez
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Mahmut Müslümanoğlu
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Gülden Acunaş
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Abdullah İğci
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Vahit Özmen
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Ahmet Dinçağ
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
| | - Neslihan Cabioğlu
- Department of General Surgery, İstanbul University, İstanbul School of Medicine, İstanbul, Turkey
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Sevim Y, Kocaay AF, Eker T, Celasin H, Karabork A, Erden E, Genc V. Breast hamartoma: a clinicopathologic analysis of 27 cases and a literature review. Clinics (Sao Paulo) 2014; 69:515-23. [PMID: 25141109 PMCID: PMC4129555 DOI: 10.6061/clinics/2014(08)03] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2013] [Accepted: 02/04/2014] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES Breast hamartoma is an uncommon breast tumor that accounts for approximately 4.8% of all benign breast masses. The pathogenesis is still poorly understood and breast hamartoma is not a well-known disorder, so its diagnosis is underestimated by clinicians and pathologists. This study was designed to present our experience with breast hamartoma, along with a literature review. METHOD We reviewed the demographic data, pathologic analyses and imaging and results of patients diagnosed with breast hamartoma between December 2003 and September 2013. RESULTS In total, 27 cases of breast hamartoma operated in the Ankara University Medicine Faculty's Department of General Surgery were included in the study. All patients were female and the mean age was 41.8±10.8 years. The mean tumor size was 3.9±2.7 cm. Breast ultrasound was performed on all patients before surgery. The most common additional lesion was epithelial hyperplasia (22.2%). Furthermore, lobular carcinoma in situ was identified in one case and invasive ductal carcinoma was observed in another case. Immunohistochemical staining revealed myoid hamartoma in one case (3.7%). CONCLUSION Breast hamartomas are rare benign lesions that may be underdiagnosed because of the categorization of hamartomas as fibroadenomas by pathologists. Pathologic examinations can show variability from one case to another. Thus, the true incidence may be higher than the literature indicates.
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Affiliation(s)
- Yusuf Sevim
- Department of General Surgery, Ankara Penal Institution Campus State Hospital, Ankara, Turkey
| | - Akin Firat Kocaay
- Department of General Surgery, Ankara University Medical School, Ankara, Turkey
| | - Tevfik Eker
- Department of General Surgery, Ankara University Medical School, Ankara, Turkey
| | - Haydar Celasin
- Department of General Surgery, Ankara Kavakl?dere Umut Private Hospital, Ankara, Turkey
| | - Ayca Karabork
- Department of Pathology, Ankara University Medical School, Ankara, Turkey
| | - Esra Erden
- Department of Pathology, Ankara University Medical School, Ankara, Turkey
| | - Volkan Genc
- Department of General Surgery, Ankara University Medical School, Ankara, Turkey
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