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Wei L, Tian Z, Wang ZY, Liu WJ, Li HB, Zhang Y. Concurrent invasive ductal carcinoma and ductal carcinoma in situ arising inside and outside a breast hamartoma: A case report. World J Clin Cases 2025; 13:101882. [DOI: 10.12998/wjcc.v13.i18.101882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2024] [Revised: 01/28/2025] [Accepted: 02/12/2025] [Indexed: 02/27/2025] Open
Abstract
BACKGROUND Breast hamartomas are rare benign breast tumors, with an incidence rate of 0.8%-4.8%. Further, the coexistence of hamartomas and carcinoma is also uncommon. Our case report presents a unique instance where invasive ductal carcinoma (IDC) and ductal carcinoma in situ were found both inside and outside a breast hamartoma. This is the second case reported in the literature.
CASE SUMMARY A 51-year-old woman presented with a 6.0 cm breast tumor on mammography and ultrasound, with suspicious areas indicative of malignant transformation. Biopsy of the suspicious area confirmed IDC with intraductal carcinoma. Breast magnetic resonance imaging showed typical hamartoma changes with irregular areas of abnormal enhancement both inside and outside. A breast-conserving surgery was performed, and postoperative pathology confirmed mammary hamartoma, concurrent with IDC and intraductal carcinoma occurring both inside and outside the hamartoma. Subsequently, appropriate adjuvant therapy was initiated. Currently, the patient is in good condition. Breast cancer may be located both inside and outside the ipsilateral mammary hamartoma, which is difficult to detect preoperatively, especially when there is a focus of intraductal carcinoma, requiring accurate assessment of the tumor extent by modern imaging techniques. Early detection of the coexistence of cancer is clinically important as it can alter patient management.
CONCLUSION This case emphasizes the importance of modern imaging techniques in accurately evaluating mammary hamartomas associated with malignancies prior to surgery.
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Affiliation(s)
- Lai Wei
- Department of Surgery, Affiliated Hospital of Beihua University, Jilin 132011, Jilin Province, China
| | - Zhe Tian
- Department of Surgery, Affiliated Hospital of Beihua University, Jilin 132011, Jilin Province, China
| | - Zhi-Yong Wang
- Department of Surgery, Affiliated Hospital of Beihua University, Jilin 132011, Jilin Province, China
| | - Wei-Jia Liu
- Department of Surgery, Affiliated Hospital of Beihua University, Jilin 132011, Jilin Province, China
| | - Hong-Bo Li
- Department of Breast and Thyroid Surgery, Jinhua People's Hospital, Jinhua 321000, Zhejiang Province, China
| | - Ying Zhang
- Department of Pathology, Affiliated Hospital of Beihua University, Jilin 132011, Jilin Province, China
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Tariq N, Dani S, Makhija P, Warren MV. Breast hamartomas associated with epithelial atypia and malignancy: are there specific clinical, radiological or pathological features that identify at risk patients? Breast Cancer Res Treat 2025; 210:393-404. [PMID: 39665864 DOI: 10.1007/s10549-024-07577-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2024] [Accepted: 11/27/2024] [Indexed: 12/13/2024]
Abstract
PURPOSE Breast hamartomas are rarely associated with epithelial atypia or malignancy. Since the introduction of digital mammography in the UK from 2008, hamartoma detection has increased. The aim of this study was to identify if there are characteristic clinical, radiological or histological features that distinguish hamartomas with intralesional atypia/malignancy (complex hamartomas, CH) or ipsilateral/contralateral atypia/malignancy (non-CH) from those without atypia/malignancy at diagnosis (other benign hamartomas, BH). METHODS We performed a retrospective single-institution review of 450 hamartomas reported between 2010 and 2023. Anonymised H&E sections and imaging of CH and non-CH were reviewed to identify distinguishing features. RESULTS 13,441 benign breast lesions were biopsied/resected between 2010 and 2023 including 450 hamartomas (3.3%), 19 of which (4.2%) were associated with atypia or malignancy. 14 were analysed further (7 CH; 7 non-CH). The mean age of CH plus non-CH patients was significantly higher than patients with BH (47.5 vs. 40.6 years; p = 0.03). The mean size of CH was greater than non-CH (32.1 mm vs.17.6 mm; p = 0.06). There was a statistically significantly higher incidence of atypical/malignant lobular lesions (ALH/LCIS/ILC) in CH vs. non-CH (42.9% vs 0%; p = 0.05). MRI was performed in 2 CH and 3 non-CH; in all 5 the associated malignancy was detected. There was no significant difference between the CH and non-CH group in ultrasound/mammographic features, other hamartoma histological features or other associated benign breast changes. CONCLUSIONS Ultrasound/mammogram are not sufficiently sensitive to identify hamartomas with associated atypia/malignancy. Certain hamartoma features may preferentially be associated with atypia/malignancy and which merit further radiological and/or detailed histological investigation.
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Affiliation(s)
- Naima Tariq
- Department of Cellular Pathology, Royal London Hospital, Bart's Health NHS Trust, London, E1 2ES, UK
- Department of Cellular Pathology, Queen's Hospital, Barking, Haveridge & Redbridge University Hospitals NHS Trust, Romford, London, RM7 0AG, UK
| | - Shefali Dani
- Department of Radiology, St. Bartholomew's Hospital, Bart's Health NHS Trust, London, EC1A 7BE, UK
| | - Purnima Makhija
- Department of Cellular Pathology, Royal London Hospital, Bart's Health NHS Trust, London, E1 2ES, UK
| | - Madhuri V Warren
- Department of Cellular Pathology, Royal London Hospital, Bart's Health NHS Trust, London, E1 2ES, UK.
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Mohamed A. Breast hamartoma: Unusual radiological presentation. Radiol Case Rep 2020; 15:2714-2717. [PMID: 33133326 PMCID: PMC7585869 DOI: 10.1016/j.radcr.2020.10.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 10/06/2020] [Accepted: 10/06/2020] [Indexed: 12/03/2022] Open
Abstract
Breast hamartomas are uncommon slowly growing lesions. Imaging findings are specific and usually relay on common mammographic picture of breast within breast appearance. I present a case of 48 years female patient, with recent history of palpable right breast mass, the imaging findings are atypical for breast hamartoma. The unusual presentation of breast hamartomas necessitates biopsy to exclude tumor. Incidence of malignancy is low, however has been reported before. Characteristic radiological imaging can help to minimize unnecessary surgery and morbidity.
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Affiliation(s)
- Abeer Mohamed
- Medical imaging Department, King Hamad University Hospital, Kingdom of Bahrain
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Forte S, Ritz A, Kubik-Huch R, Leo C. Invasive ductal carcinoma detected within a fibroadenolipoma through digital breast tomosynthesis. Acta Radiol Open 2019; 8:2058460119865905. [PMID: 31384485 PMCID: PMC6659190 DOI: 10.1177/2058460119865905] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 07/02/2019] [Indexed: 12/01/2022] Open
Abstract
A 52-year-old patient referred to our hospital for a screening mammogram showed a
suspicious new architectural distortion. Previously, a fibroadenolipoma within
the right breast was diagnosed clinically and radiologically. Further work-up
with tomosynthesis, magnetic resonance imaging, and magnetic resonance-guided
biopsy showed an invasive ductal carcinoma within the fibroadenolipoma, which
are usually benign breast lesions not associated with malignancy. This case
report offers a review of the literature and a discussion of signs, which should
alert the radiologist.
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Affiliation(s)
- Serafino Forte
- Kantonsspital Baden AG, Institute of Radiology, Baden, Switzerland
| | - Anna Ritz
- Kantonsspital Baden AG, Institute of Radiology, Baden, Switzerland
| | - Rahel Kubik-Huch
- Kantonsspital Baden AG, Institute of Radiology, Baden, Switzerland
| | - Cornelia Leo
- Kantonsspital Baden AG, Institute of Radiology, Baden, Switzerland
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5
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[Rare benign breast tumors including Abrikossoff tumor (granular cell tumor), erosive adenomatosis of the nipple, cytosteatonecrosis, fibromatosis (desmoid tumor), galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma: Guidelines for clinical practice]. ACTA ACUST UNITED AC 2015; 44:1030-48. [PMID: 26530177 DOI: 10.1016/j.jgyn.2015.09.034] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2015] [Accepted: 09/18/2015] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To provide guidelines for clinical practice from the French College of Gynaecologists and Obstetricians (CNGOF), based on the best evidence available, concerning rare benign breast tumors: Abrikossoff (granular cell tumor), erosive adenomatosis of the nipple, cytosteatonecrosis, fibromatosis (desmoid tumor), galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma. METHODS Bibliographical search in French and English languages by consultation of Pubmed, Cochrane and international databases. RESULTS For erosive adenomatosis of the nipple, surgical excision is recommended to exclude Paget's disease or cancer (grade C). When surgery is performed for breast desmoid tumor or syringomatous adenoma, free margins are recommended (grade C). Without clinico-radio-histologic discordance, surgical abstention may be proposed for Abrikossoff tumor (granular cell tumor), cytosteatonecrosis, galactocele, hamartoma, hemangioma, lipoma, juvenile papillomatosis, pseudoangiomatous hyperplasia, and syringomatous adenoma (grade C).
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6
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Su CC, Chen CJ, Kuo SJ, Chen DR. Myoid hamartoma of the breast with focal chondromyoxid metaplasia and pseudoangiomatous stromal hyperplasia: A case report. Oncol Lett 2015; 9:1787-1789. [PMID: 25789043 PMCID: PMC4356416 DOI: 10.3892/ol.2015.2892] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2014] [Accepted: 01/08/2015] [Indexed: 11/30/2022] Open
Abstract
Hamartomas of the breast, also known as fibroadenolipomas, lipofibroadenomas or adenolipomas, are benign lesions. Hamartomas account for between 0.04 and 1.15% of all benign breast tumors in females. Myoid hamartoma of the breast (MHB) is extremely rare. The present study describes a case of MHB in a 44-year-old female. Screening mammography revealed a lobulated partial indistinct isodense mass measuring ~3.8 cm in the upper outer quadrant of the left breast. Sonographic examinations revealed a 2–3-cm mass in the left breast, which was fairly well circumbscribed and demonstrated complex scattered echogenic areas and isoechoic tissue. A core needle biopsy demonstrated fibrocystic changes, with small focal ductule aggregations. As malignancy could not be excluded, a partial mastectomy was performed using a circumareolar incision. The mass was histopathologically diagnosed as MHB with focal chondromyoxid metaplasia and pseudoangiomatous stromal hyperplasia. The histological diagnosis was based upon the findings of the well-circumscribed tumor, which was composed of entrapped mammary ducts, fat cells and myoid stromal components, with focal chondromyxoid metaplasia and pseudoangiomatous stromal hyperplasia. The tumor cells exhibited diffuse cluster of differentiation 34-positive immunoreactivity, which was consistent with a diagnosis of pseudoangiomatous stromal hyperplasia.
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Affiliation(s)
- Chin-Cheng Su
- Tumor Research Center of Integrative Medicine, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; Department of Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung 40402, Taiwan, R.O.C
| | - Chih-Jung Chen
- Department of Surgical Pathology, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan, R.O.C. ; Department of Medical Technology, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 356, Taiwan, R.O.C
| | - Shou-Jen Kuo
- Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; Department of Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C
| | - Dar-Ren Chen
- Comprehensive Breast Cancer Center, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C. ; Department of Surgery, Changhua Christian Hospital, Changhua 50006, Taiwan, R.O.C
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7
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Cazorla S, Arentz C. Breast hamartomas – Differential consideration in slow developing breast asymmetry. JPRAS Open 2015. [DOI: 10.1016/j.jpra.2014.12.004] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Lambert J, Jerjir N, Casselman J, Steyaert L. Invasive lobular carcinoma arising in a hamartoma of the breast: a case report. Clin Breast Cancer 2014; 15:e63-6. [PMID: 25240620 DOI: 10.1016/j.clbc.2014.07.011] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 07/10/2014] [Indexed: 11/15/2022]
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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: 1.8] [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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10
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Sonmez FC, Gucin Z, Yildiz P, Tosuner Z. Hamartoma of the breast in two patients: A case report. Oncol Lett 2013; 6:442-444. [PMID: 24137343 PMCID: PMC3789047 DOI: 10.3892/ol.2013.1366] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2013] [Accepted: 05/14/2013] [Indexed: 12/05/2022] Open
Abstract
Breast hamartomas are rare, benign, tumor-like nodules composed of glandular, adipose and fibrous tissue. The hamartoma was first described in 1971 as a lipofibroadenoma, fibroadenolipoma or adenolipoma, based on the predominant component of the breast tissue. Clinical findings resemble fibroadenoma and if there is a palpable mass, the patients may receive an immediate diagnosis. Ductal hyperplasia, apocrine metaplasia, calcification and adenosis may occur within the hamartoma, with rarer instances of lobular or ductal intraepithelial neoplasms. Although hamartoma is usually benign, a malignant transformation is possible. An excision and histological examination is necessary for the differential diagnosis and also for any epithelial lesions of the hamartoma. Simple excision is enough for treatment if there is no coincidental epithelial malignant lesion. The patients in the present study were treated by simple excision as there were no proliferative changes in the lesions. No recurrence or other problems were detected in the 18-month follow-up. The current study presents two cases of breast hamartoma that were diagnosed as an adenolipoma and a fibroadenolipoma, and then describes the macroscopic and microscopic observations of these lesions.
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Affiliation(s)
- Fatma Cavide Sonmez
- Department of Pathology, Faculty of Medicine, Bezmialem Vakif University, Istanbul 34093, Turkey
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11
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Ayyappan AP, Crystal P, Torabi A, Foley BJ, Fornage BD. Imaging of fat-containing lesions of the breast: a pictorial essay. JOURNAL OF CLINICAL ULTRASOUND : JCU 2013; 41:424-433. [PMID: 23836049 DOI: 10.1002/jcu.22070] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/04/2013] [Accepted: 05/22/2013] [Indexed: 06/02/2023]
Abstract
Fat-containing breast lesions constitute a heterogeneous group of predominantly benign tumors and non-neoplastic conditions. The role of imaging is to distinguish leave-me-alone lesions from rarely occurring malignant fat-containing tumors that require histologic analysis. Correlating mammographic findings with appearance at ultrasonography often helps in identifying lesions that do not require further work-up. MRI can be valuable to confirm the presence of fat and characterize lesions indeterminate on conventional imaging. The purpose of this multimodality imaging review is to exemplify the radiologic appearances of common and uncommon fat-containing breast lesions to facilitate accurate diagnosis, avoid unnecessary interventions, and ensure appropriate management.
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Affiliation(s)
- Anoop Padoor Ayyappan
- Department of Radiology, 4800 Alberta Avenue, Texas Tech University Health Sciences Center, Paul L Foster School of Medicine, El Paso, Texas 79905, USA
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12
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Choi N, Ko ES. Invasive ductal carcinoma in a mammary hamartoma: case report and review of the literature. Korean J Radiol 2010; 11:687-91. [PMID: 21076596 PMCID: PMC2974232 DOI: 10.3348/kjr.2010.11.6.687] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2010] [Accepted: 07/20/2010] [Indexed: 11/15/2022] Open
Abstract
Mammary hamartomas are typically a benign condition and rarely develop into malignant lesions. Only 14 cases of carcinomas associated with a hamartoma have been documented in the literature. In this case report, we describe a case of invasive ductal carcinoma within a hamartoma in a 72-year-old woman. Mammography, ultrasonography, and magnetic resonance imaging showed the features of a typical hamartoma with a suspicious mass arising in it. This case illustrates the importance of identification of unusual findings in a typical mammary hamartoma on radiologic examinations.
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Affiliation(s)
- Nami Choi
- Department of Radiology, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
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13
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14
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Breast cancer associated with mammary hamartoma. Breast Cancer 2009; 19:183-6. [DOI: 10.1007/s12282-009-0147-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2008] [Accepted: 06/08/2009] [Indexed: 10/20/2022]
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15
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Harvey JA, Nicholson BT, Cohen MA. Finding Early Invasive Breast Cancers: A Practical Approach. Radiology 2008; 248:61-76. [DOI: 10.1148/radiol.2481060339] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Chao TC, Chao HH, Chen MF. Sonographic features of breast hamartomas. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:447-52; quiz 453. [PMID: 17384041 DOI: 10.7863/jum.2007.26.4.447] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
OBJECTIVE The purpose of this study was to elucidate the sonographic characteristics of breast hamartomas. METHODS Data and sonographic images of 14 breast hamartomas were retrospectively reviewed. RESULTS All patients had clinically palpable lumps. The median patient age was 39.5 years (range, 24-60 years). Eleven (78.6%) tumors occurred in the right breast, and 3 (21.4%) were in the left. The median tumor size measured by sonography was 2.8 cm (range, 1.2-4.9 cm). The median longest transverse dimension-anteroposterior diameter ratio of the tumors was 2.44 (range, 1.52-3.73). All tumors were oval and compressible with transducer pressure. Thirteen (92.9%) tumors were well circumscribed with smooth tumor margins, and 1 (7.1%) had indistinct margins. The internal echo texture was hyperechoic in 6 (42.9%), mixed (heterogeneous) echogenicity in 5 (35.7%), and isoechoic in 3 (21.4%). Four (28.6%) tumors had echogenic halos, and 2 (14.3%) had anechoic halos. Ten (71.4%) tumors had no retrotumor acoustic phenomena. Two (14.3%) had bilateral edge shadowing; 1 (7.1%) had posterior enhancement; and 1 (7.1%) had a mixture of enhancement and shadowing. CONCLUSIONS Breast hamartomas were well-circumscribed, solid, oval tumors without intratumor microcalcification. The internal echo texture of most hamartomas is either hyperechoic or composed of mixed echogenicity. Retrotumor acoustic phenomena were absent in most hamartomas.
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Affiliation(s)
- Tzu-Chieh Chao
- Division of General Surgery, Department of Surgery, Chang Gung University College of Medicine and Chang Gung Memorial Hospital, Taoyuan, Taiwan.
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Oueslati S, Salem A, Chebbi A, Mhiri S, Kribi L, Ben Romdhane K, Rajhi H, Hamza R, Mnif N. Hamartome du sein. IMAGERIE DE LA FEMME 2007. [DOI: 10.1016/s1776-9817(07)88603-2] [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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18
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Ruiz-Tovar J, Reguero-Callejas ME, Aláez AB, Ramiro C, Rojo R, Collado MV, González-Palacios F, Muñoz J, García-Villanueva A. Infiltrating ductal carcinoma and ductal carcinoma in situ associated with mammary hamartoma. Breast J 2006; 12:368-70. [PMID: 16848850 DOI: 10.1111/j.1075-122x.2006.00279.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Mammary hamartoma is a rare nonmalignant lesion. Only 11 cases of carcinoma associated with hamartoma have been previously described in the literature. We describe a case of infiltrating ductal carcinoma (IDC) and ductal carcinoma in situ (DCIS) associated with hamartoma in a 35-year-old woman. Mammography showed the features of a typical hamartoma with suspicious microcalcifications arising in it. The patient underwent a radical modified mastectomy. It is likely that hamartoma is a coincidental finding. The identification of suspicious microcalcifications in a typical mammographic image of a hamartoma should prompt continued examination to exclude an underlying tumor.
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MESH Headings
- Adult
- Breast Diseases/complications
- Breast Diseases/pathology
- Breast Diseases/surgery
- Breast Neoplasms/complications
- Breast Neoplasms/pathology
- Breast Neoplasms/surgery
- Carcinoma, Ductal, Breast/complications
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/surgery
- Carcinoma, Intraductal, Noninfiltrating/complications
- Carcinoma, Intraductal, Noninfiltrating/pathology
- Carcinoma, Intraductal, Noninfiltrating/surgery
- Female
- Hamartoma/complications
- Hamartoma/pathology
- Hamartoma/surgery
- Humans
- Mastectomy
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Affiliation(s)
- Jaime Ruiz-Tovar
- Department of Surgery, University Hospital Ramón y Cajal, Madrid, Spain.
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Ruiz Tovar J, Reguero Callejas ME, Aláez Chillarón AB, Ramiro Pérez C, Collado Guirao MV, Rojo Blanco R, Muñoz Martín-Cámara J, González-Palacios F, García Villanueva A. Mammary hamartoma. Clin Transl Oncol 2006; 8:290-3. [PMID: 16648106 DOI: 10.1007/bf02664941] [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: 10/23/2022]
Abstract
INTRODUCTION Mammary hamartomas are rare benign breast lumps. They are usually painless, wellcircumscribed, mobile and with no adherence to skin or muscle, composed of varying amounts of fat, glandular and fibrous tissue. Mammary hamartoma has been classically considered as an underdiagnosed pathology, but with the increasing use of diagnostic procedures in breast tumours, the number of hamartomas has increased in the last years. Because there is no distinct pathological feature, a correlation with the clinical findings and image techniques is necessary in order to achieve a correct diagnosis of the pathology. MATERIALS AND METHODS The clinicopathological features of 8 mammary hamartomas are reported here. RESULTS The patients are ranged in age from 34 to 67 years. The initial manifestation was in all cases a well-circumscribed, soft, palpable breast lump. Mammography was performed in all patients. Other diagnostic procedures used in the diagnosis were Ultrasound, Fine Needle Aspiration Cytology and Needle Core Biopsy. Treatment was tumorectomy. We describe a case of recurrence after excision of the lump in a more aggressive histological form and one patient who presented the coexistence of a mammary hamartoma and an invasive ductal carcinoma. CONCLUSION Mammary hamartoma is an uncommon breast tumour. It is necessary the correlation between pathology and clinical and radiological findings. We express our management plan for these lesions.
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Affiliation(s)
- J Ruiz Tovar
- Department of General Surgery and Digestive System, University Hospital Ramón y Cajal, Madrid, Spain.
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Georgian-Smith D, Kricun B, McKee G, Yeh E, Rafferty EA, D'Alessandro HA, Kopans DB. The mammary hamartoma: appreciation of additional imaging characteristics. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2004; 23:1267-1273. [PMID: 15448315 DOI: 10.7863/jum.2004.23.10.1267] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
OBJECTIVE To determine the mammographic and sonographic findings of hamartomas that were not classic on imaging, how pathologists distinguish the hamartoma from benign breast tissue on core samples, and reasons for discrepancies between core and surgical biopsy. METHODS A retrospective review of all image-recommended core biopsies between 1993 and 2001 was performed. There were 41 cases of hamartomas found on either core or surgical biopsy. The mammographic, sonographic, and pathologic findings were reviewed. RESULTS Of 41 hamartomas in 38 patients, 18 went on to surgical biopsy. Of these 18 cases, 4 cases of hamartoma on core biopsy were fibroadenoma after excision; 2 cases of hamartoma on core biopsy were confirmed by surgery; and 12 cases of fibrocystic change after core biopsy were hamartoma after surgical biopsy. The 4 cases of fibroadenoma shown at final pathologic examination were excluded from imaging review, leaving 37 cases. In the 20 patients who underwent only core sampling, 23 hamartomas were diagnosed. Seventeen masses were visible on mammography, and 82% were homogeneously dense. Of 36 masses shown on sonography, 86% were uniformly hypoechoic. At histologic examination, only 16% contained fat within the mass. CONCLUSIONS Hamartomas may appear as homogeneously dense, well-circumscribed masses, varying in appearance from the classically described encapsulated mixed fatty-fibroglandular mass. Pathologists can make the diagnosis of hamartoma without the presence of adipose tissue but may have difficulty in distinguishing the hamartoma from fibrocystic change. However, if there is radiologic-pathologic concordance, further surgical excision is not warranted.
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Affiliation(s)
- Dianne Georgian-Smith
- Department of Radiology, Massachusetts General Hospital, Wang Ambulatory Care Center 219Q, 15 Parkman St, Boston, MA 02114, USA.
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Le cancer du sein : les images orphelines. IMAGERIE DE LA FEMME 2004. [DOI: 10.1016/s1776-9817(04)94789-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Los hamartomas de la mama. CLINICA E INVESTIGACION EN GINECOLOGIA Y OBSTETRICIA 2004. [DOI: 10.1016/s0210-573x(04)77334-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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