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AlSharif S, Alshamrani KM, Scaranelo A, Khoumais N, Subahi A, Mesurolle B. Unusual Male Breast Lesions. J Clin Imaging Sci 2021; 11:21. [PMID: 33948337 PMCID: PMC8088480 DOI: 10.25259/jcis_43_2021] [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] [Received: 02/27/2021] [Accepted: 03/18/2021] [Indexed: 12/18/2022] Open
Abstract
Most of male breast masses are benign with gynecomastia being the most common entity encountered. Primary male breast cancer accounts for less than 1% of the total number of breast cancer. Male breast can be affected by a variety of conditions affecting the female breast with less frequency due to the lack of hormonal influence and consequent glandular sub-development. Imaging features of male breast masses are quite similar to the female breast. Therefore, using the knowledge of the female breast and applying it may help in the diagnosis and management of male breast abnormalities. In this article, we aim to review a variety of unusual male breast masses. We discuss the demographics of male breast tumors, describe the diagnostic algorithm for evaluating male breast masses, and review the imaging features of rare breast masses and mimickers of male breast cancer.
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Affiliation(s)
- Shaza AlSharif
- Department of Medical Imaging, Ministry of the National Guard - Health Affairs, Saudi Arabia.,Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Khalid Misfer Alshamrani
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia.,King Abdullah International Medical Research Center, Jeddah, Saudi Arabia
| | - Anabel Scaranelo
- Department of Medical Imaging, University of Toronto, Toronto, Canada
| | - Nuha Khoumais
- Department of Radiology, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - Ahmad Subahi
- Department of Radiological Sciences, College of Applied Medical Sciences, King Saud bin Abdulaziz University for Health Sciences, Saudi Arabia.,Department of Basic Sciences, College of Science and Health Professions, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia
| | - Benoit Mesurolle
- Department of Radiology, Pôle Santé République, Clermont-Ferrand, France
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Salemis NS. Sinusoidal hemangioma of the breast: diagnostic evaluation management and literature review. Gland Surg 2017; 6:105-109. [PMID: 28210560 DOI: 10.21037/gs.2016.11.06] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Vascular tumors of the breast are rare and may pose a diagnostic challenge. Breast hemangioma is a very rare benign vascular neoplasm accounting for 0.4% of all breast tumors. It is most commonly detected as an incidental microscopic finding in biopsy specimens obtained for unrelated reasons. We describe here a very rare case of a sinusoidal breast hemangioma in a postmenopausal patient who presented with a palpable breast mass. A complete surgical resection was performed because the tumor exhibited atypical imaging features. We conclude that although in carefully selected cases of breast hemangioma a conservative management with follow up imaging is a reasonable option, in cases with atypical imaging or pathological characteristics a complete surgical resection of the vascular tumor is mandatory in order to exclude the possibility of an underlying angiosarcoma.
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Affiliation(s)
- Nikolaos S Salemis
- Breast Unit, 2nd Department of Surgery, Army General Hospital, Athens, Greece
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Vascular tumours of the breast: a comprehensive review with focus on diagnostic challenges encountered in the core biopsy setting. Pathology 2016; 49:197-214. [PMID: 28049578 DOI: 10.1016/j.pathol.2016.11.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 11/04/2016] [Accepted: 11/06/2016] [Indexed: 12/20/2022]
Abstract
Vascular proliferations of the breast comprise a spectrum of benign and malignant lesions. In limited samples, such as core needle biopsies (CNB), these lesions may be difficult to distinguish due to significant overlap in morphological features. As the treatment and prognosis of these entities vary widely, it is important for pathologists to consider a complete differential diagnosis and correctly synthesise histological features, results of adjunctive immunohistochemical studies, and pertinent clinical and imaging information, to render an accurate diagnosis in such limited samples. The diagnostic pitfalls of under- or overdiagnosis of vascular lesions sampled in CNB will also be discussed.
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Funamizu N, Tabei I, Sekine C, Fuke A, Yabe M, Takeyama H, Okamoto T. Breast hemangioma with difficulty in preoperative diagnosis: a case report. World J Surg Oncol 2014; 12:313. [PMID: 25312096 PMCID: PMC4200173 DOI: 10.1186/1477-7819-12-313] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2014] [Accepted: 10/03/2014] [Indexed: 11/10/2022] Open
Abstract
We report a rare case of breast hemangioma found in a 70-year-old Japanese female. Before seeking medical attention, the patient noticed a hard mass in her right breast but denied associated symptoms. A mammography revealed a well-circumscribed, highly dense, lobular nodule located in the middle inter portion of the right breast. To verify this finding, we used ultrasonography which revealed an irregular, iso-echoic nodule measuring 10 mm in the same portion. Based on these findings, we suspected a malignancy and performed a core needle biopsy. Unexpectedly, a histological examination of the biopsy displayed normal vasculature, adipose, and mammary tissues. In order to make an accurate diagnosis, the mass was surgically excised under general anesthesia and sent to pathology. Pathological findings of the mass were positive for breast hemangioma, and the patient has had no recurrence of the disease for the past 24 months.
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Affiliation(s)
- Naotake Funamizu
- Department of Surgery, The Jikei University School of Medicine, Daisan Hospital, 4-22-1, Izumi honnmachi, Komae-city, Tokyo 201-8601, Japan.
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Ciurea A, Dudea SM, Lebovici A, Fodor L, Crisan D. Diffuse angiomatosis of the breast--sonographic appearance. JOURNAL OF CLINICAL ULTRASOUND : JCU 2014; 42:498-501. [PMID: 24965677 DOI: 10.1002/jcu.22199] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2013] [Revised: 12/13/2013] [Accepted: 06/09/2014] [Indexed: 06/03/2023]
Abstract
Angiomatosis or diffuse hemangioma is a very rare benign vascular tumor, consisting of blood and lymphatic channels growing diffusely in the breast parenchyma. We report a case of diffuse breast angiomatosis in a 34-year-old woman with pubertal anisomastia. Ultrasound raised the suspicion of vascular tumor, by showing large cystic spaces separated by septae with moderate blood flow, similar to those found in cystic lymphangioma. We discuss the imaging (mammography, ultrasound, and MRI) and pathologic findings, with a brief review of the literature.
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Affiliation(s)
- Anca Ciurea
- Department of Radiology, University of Medicine and Pharmacy "I. Hatieganu" Cluj-Napoca, 400023, Cluj-Napoca, Romania
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Lattin GE, Jesinger RA, Mattu R, Glassman LM. From the radiologic pathology archives: diseases of the male breast: radiologic-pathologic correlation. Radiographics 2013; 33:461-89. [PMID: 23479708 DOI: 10.1148/rg.332125208] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Male breast disease includes a variety of benign and malignant conditions, many of which are hormonally influenced. Gynecomastia and skin lesions account for the majority of conditions in symptomatic men with a palpable abnormality, and these conditions should be accurately recognized. Imaging patterns of gynecomastia include nodular, dendritic, and diffuse patterns. Histopathologically, the nodular and dendritic patterns correlate with the florid and quiescent (fibrotic) phases of gynecomastia, respectively. The diffuse pattern may have features of both phases and is associated with exposure to exogenous estrogen. Benign-appearing palpable masses in male patients should be approached cautiously, given the overlapping morphologic features of benign and malignant tumors. In addition to gynecomastia, other benign male breast tumors include lipoma, pseudoangiomatous stromal hyperplasia, granular cell tumor, fibromatosis, myofibroblastoma, schwannoma, and hemangioma. Male breast cancer accounts for 1% of all breast carcinomas. Invasive ductal carcinoma accounts for the majority of cases in adult males and typically appears as a subareolar mass without calcifications that is eccentric to the nipple. Other epithelial and mesenchymal tumors that may occur, albeit not as commonly as in women, include papillary carcinoma, invasive lobular carcinoma, adenoid cystic carcinoma, liposarcoma, dermatofibrosarcoma, pleomorphic hyalinizing angiectatic tumor, basal cell carcinoma of the nipple, hematopoietic malignancies, and secondary tumors. Knowledge of the natural history, clinical characteristics, and imaging features of tumors that occur in the male breast will help narrow the radiologic differential diagnosis and optimize treatment.
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Affiliation(s)
- Grant E Lattin
- Department of Radiology and Radiological Sciences, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Rd, Bethesda, MD 20814, USA.
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Conde DM, de Paula ÉC, Jales RM, de Paula HM, de Sousa JA. A clinically palpable cavernous hemangioma of the breast in an 80-year old woman. Eur J Obstet Gynecol Reprod Biol 2013; 167:236-7. [PMID: 23280280 DOI: 10.1016/j.ejogrb.2012.12.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2012] [Revised: 11/11/2012] [Accepted: 12/04/2012] [Indexed: 11/19/2022]
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8
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Tilve A, Mallo R, Pérez A, Santiago P. Breast hemangiomas: correlation between imaging and pathologic findings. JOURNAL OF CLINICAL ULTRASOUND : JCU 2012; 40:512-517. [PMID: 22434703 DOI: 10.1002/jcu.21904] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 01/27/2012] [Indexed: 05/31/2023]
Abstract
Hemangiomas are benign vascular tumors that are rare in the breast. A high percentage of hemangiomas are diagnosed incidentally during imaging examinations. They have mammographic, sonographic, and pathologic characteristics that allow radiologists and pathologists to diagnose them. We present four different cases of breast hemangiomas showing their mammographic and sonographic features. Two were diagnosed with an 18-gauge core needle biopsy and they underwent surgical excision. The other two cases were diagnosed with a 14-gauge core needle biopsy and their radiologic and pathologic appearances were concordant with breast hemangiomas, so they did not need surgical excision and are being followed.
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Affiliation(s)
- Amara Tilve
- Radiology Department, Complexo Hospitalario Universitario de Vigo, Pizarro 22, 36204 Vigo, Spain
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Ferru JM. [Hemangioma of the breast: mammographic, sonographic and MRI features]. JOURNAL DE RADIOLOGIE 2011; 92:441-5. [PMID: 21621112 DOI: 10.1016/j.jradio.2011.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Revised: 06/27/2010] [Accepted: 03/08/2011] [Indexed: 11/30/2022]
Affiliation(s)
- J-M Ferru
- Service d'imagerie de la femme, clinique du Parc, 50 rue Emile-Combes, Castelnau-le-Lez, France.
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Linda A, Zuiani C, Lorenzon M, Furlan A, Londero V, Machin P, Bazzocchi M. The wide spectrum of hyperechoic lesions of the breast. Clin Radiol 2011; 66:559-65. [PMID: 21371696 DOI: 10.1016/j.crad.2010.12.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Revised: 12/06/2010] [Accepted: 12/14/2010] [Indexed: 11/30/2022]
Abstract
Although breast lesions are commonly detected because of their hypoechogenicity, some lesions may present with hyperechogenicity due to their histological components. Hyperechogenicity has been shown to be highly predictive of benignity; however, hyperechoic lesions can occasionally be malignant. This article reviews hyperechoic lesions of the breast, describes the underlying histological causes associated with hyperechogenicity, and the sonographic features useful for the differential diagnosis between benign and malignant hyperechoic lesions.
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Affiliation(s)
- A Linda
- Institute of Diagnostic Radiology, University of Udine, Azienda Ospedaliero-Universitaria Santa Maria della Misericordia, Udine, Italy.
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Leddy R, Cluver A. Mammographic and sonographic characteristics of a cavernous hemangioma in a male patient. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2010; 29:645-649. [PMID: 20375384 DOI: 10.7863/jum.2010.29.4.645] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Rebecca Leddy
- Department of Radiology, MSC 323, Medical University of South Carolina, 96 Jonathan Lucas St, Room 210 CSB, Charleston, SC 29425-3230, USA.
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Kim SH, Lee JH, Kim DC, Song BJ. Subcutaneous venous hemangioma of the breast. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:1097-100. [PMID: 17646373 DOI: 10.7863/jum.2007.26.8.1097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Sung Hun Kim
- Department of Radiology, Kangnam St Mary's Hospital, Catholic University of Korea, 505 Banpo-Dong, Seocho-Gu, Seoul, Korea
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Kim SJ, Han HS, Kim JS, Park JH, Jeon HJ, Yi JG. Cavernous hemangioma of the breast parenchyma with unusual features. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2006; 25:1343-6. [PMID: 16998110 DOI: 10.7863/jum.2006.25.10.1343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Affiliation(s)
- Seung Ja Kim
- Department of Radiology, Konkuk University Hospital, 4-12 Hwayang-dong, Gwangjin-gu, Seoul 143-729, Korea.
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Glazebrook KN, Morton MJ, Reynolds C. Vascular Tumors of the Breast: Mammographic, Sonographic, and MRI Appearances. AJR Am J Roentgenol 2005; 184:331-8. [PMID: 15615997 DOI: 10.2214/ajr.184.1.01840331] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Affiliation(s)
- Katrina N Glazebrook
- Department of Radiology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905, USA
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Mesurolle B, Wexler M, Halwani F, Aldis A, Veksler A, Kao E. Cavernous hemangioma of the breast: mammographic and sonographic findings and follow-up in a patient receiving hormone-replacement therapy. JOURNAL OF CLINICAL ULTRASOUND : JCU 2003; 31:430-436. [PMID: 14528442 DOI: 10.1002/jcu.10193] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
We report the case of a 78-year-old woman who had been receiving hormone-replacement therapy (HRT) for 6 years and had a 4-month history of a painless nodule in the 9 o'clock position in her right breast. Mammography performed 4 years previously had shown a 4-mm bilobed, ovoid, well-defined nodule in that location; mammography performed 1 year previously had shown that the nodule had increased to 6 mm. We performed mammographic and sonographic examinations, which revealed a 10-mm ovoid nodule in the same 9 o'clock position in the right breast. The imaging findings appeared to indicate benignity, but because of the increasing size of the nodule, we undertook an ultrasound-guided large-core needle biopsy. The histopathologic diagnosis was typical cavernous hemangioma. It was not excised, but HRT was discontinued. Follow-up mammography and sonography 8 months later showed that the nodule had decreased to 6 mm. We believe that the HRT played a contributory role in the increasing size of this patient's cavernous hemangioma. The use of ultrasound-guided large-core needle biopsy is reliable enough to ascertain the benignity of such masses and can thus avoid, if it is clinically appropriate, the need for their surgical removal.
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Affiliation(s)
- Benoît Mesurolle
- Department of Radiology, Cedar Breast Center, McGill University, Royal Victoria Hospital, 687 Pine Avenue West, Montreal, Quebec, H3A 1A1, Canada
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