Cytopathologic diagnosis of spontaneous infarction of fibroadenoma of the breast

Giant fibroadenoma with massive infarction masquerading as malignancy: a case report

Fibroadenoma is a common benign breast lesion that usually affects women in their second and third decade of life and usually present as small mobile painless lump. However, it is important to recognize that a small percentage have been shown to progress to giant fibroadenomas. Giant fibroadenomas can undergo infarction leading to significant morbidity and difficulty to distinguish from the more aggressive phyllodes tumors or carcinoma. We report an interesting case of giant fibroadenoma (17 × 11 × 7 cm) with massive infarction during lactation, further complicated by lactational mastitis with close resemblance to cystosarcoma phyllodes. Detailed clinical evaluation and proper investigation in the form of USG breast and PET-CT scan helped us to delineate the nature of pathology. Simple excision of lesion with curvilinear incision was done with excellent cosmetic outcome. Histopathologic features were consistent with fibroadenoma (giant) with large areas of infarction. Fibroadenoma breast has varied clinical presentations. The course of disease may be complicated by pregnancy, lactation and inflammatory processes. Massive infarction may make the picture more dubious and masquerade with malignant transformation altering our treatment decision. The presence of necrosis on core biopsy or intra-operative finding should be cautiously interpreted and is not itself a sign of malignancy. Detailed clinical evaluation and comprehensive workup should be done before embarking on radical treatment.

Spontaneous infarcted adenoma of the mammary gland in a Wistar Hannover GALAS rat

Spontaneous massive infarction of mammary gland tumors has been reported to occur infrequently in humans. A subcutaneous mass (18 × 17 × 10 mm) was observed in the right axilla extending to the chest region of a 110-week-old female Wistar Hannover GALAS rat. Histopathologically, a well-circumscribed mass with lobular structures was present in the subcutis. Most of the mass was occupied by extensive coagulative necrosis of neoplastic cells with relatively uniform acinar and ductal structures. Although each necrotic acinar structure was separated by reticular fibers, periacinar stromal collagen fibers were not abundant. Considering the site of occurrence and histological features, the necrotic tissue was diagnosed as adenoma of the mammary gland. The necrotic region lacked hemorrhage and obvious inflammatory cell infiltration, indicating the necrosis was caused by infarction. Although multiple necrosis and focal infarction are occasionally observed in large-sized tumors in rodents, especially in adenocarcinomas, the present case was characteristic, with the massive infarction involving most parts of the tumor despite the relatively small size and low atypia of neoplastic cells. This is a rare case of spontaneous infarcted adenoma of the mammary gland in rats histologically resembling human cases.

Spontaneous infarction of fibroadenoma of breast-A case report with literature review

INTRODUCTION

Infarction of breast fibroadenoma is a very rare complication which is either spontaneous or secondary to trauma. It poses a diagnostic dilemma of inflammatory carcinoma. We report a case of spontaneous infarction of fibroadenoma with different clinical presentation.

CASE REPORT

A 26-year-old female presented with right breast lump with sudden increase in size for 2 week duration. On examination, well defined, irregular lump measuring 6×3cm and firm to hard in consistency was found. The clinical diagnosis of benin fibroadenoma of the breast was made. Ultrasound confirmed the diagnosis. biopsy was planned. Macroscopical and microscopical examination showed pictures consistent with spontaneous infarction of benign fibroadenoma of breast.

DISCUSSION

Fibroadenomas are the most common benign tumor of breast among female gender. Spontaneous infarction within fibroadenoma is a very rare. To our knowledge, only 33 cases have been reported in literatures.

CONCLUSION

Spontaneous infarction of the fibroadenoma is a benign condition of the breast with features either inflammatory carcinoma or the same presentation of benign fibroadenoma.