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1
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Elayyan R, Rizk M, Shah C, Price R, Garg N. Mammary myofibroblastoma of the male breast: a case report and literature review. Ann R Coll Surg Engl 2024. [PMID: 39435535 DOI: 10.1308/rcsann.2024.0076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2024] Open
Abstract
Mammary myofibroblastoma (MFB) is a rare benign spindle cell tumour predominantly affecting males, but also observed in postmenopausal females. Its diagnosis remains challenging owing to overlapping histological features with malignant lesions and limited tissue sampling in core biopsies. We present a case of incidentally discovered mammary MFB in a 63-year-old man and review its clinical, radiological and histopathological characteristics. The patient, who had a history of distal pancreatectomy and splenectomy, presented with an incidental left anterior chest wall nodule discovered on computed tomography scan. Clinical examination revealed a benign left retroareolar lump, confirmed by breast ultrasound and mammography. Ultrasound-guided core biopsy demonstrated characteristic spindle cells, prompting immunohistochemical staining confirming the diagnosis of MFB. The lesion was surgically excised with clear margins. Mammary MFB is commonly seen in postmenopausal women and older men, presenting as painless, mobile breast lumps. Imaging findings are nonspecific, resembling fibroadenomas or fat necrosis. Histologically, MFB lacks mammary ducts or lobules and displays characteristic spindle cells with collagenous stroma. Immunohistochemistry aids in differentiating it from other spindle cell tumours. Surgical excision is curative, with no reported cases with recurrence. Mammary MFB should be considered in the differential diagnosis of breast masses in males and postmenopausal women. Despite the challenges in diagnosis, its benign nature and favourable prognosis warrant timely recognition and appropriate management through surgical excision. Further research is needed to establish clear management guidelines and explore its underlying pathogenesis.
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Affiliation(s)
- R Elayyan
- King's College Hospital NHS Foundation Trust, UK
| | - M Rizk
- King's College Hospital NHS Foundation Trust, UK
| | - C Shah
- King's College Hospital NHS Foundation Trust, UK
| | - R Price
- King's College Hospital NHS Foundation Trust, UK
| | - N Garg
- King's College Hospital NHS Foundation Trust, UK
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Hassan RE, Raza M, Hamad SB, Vasudevan K, Abbas J. An Unexpected Giant: A Case of Massive Paratesticular Extra-mammary Myofibroblastoma. Cureus 2024; 16:e66856. [PMID: 39280406 PMCID: PMC11398836 DOI: 10.7759/cureus.66856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/14/2024] [Indexed: 09/18/2024] Open
Abstract
Mammary-type myofibroblastomas (MFBs) are benign spindle cell tumors, typically presenting in common locations such as the breast, abdomen, and inguinal region. We present a case of a 66-year-old male with a four-year history of painless scrotal swelling. The preoperative diagnosis was challenging, with an initial suspicion of soft tissue sarcoma. A complete surgical excision was performed, revealing a well-circumscribed, encapsulated mass. The tumor measured 30 x 20 x 14 cm, weighing 5.28 kg. Histopathology confirmed an MFB. This exceptionally large paratesticular MFB emphasizes the diagnostic difficulty of such tumors. Surgical resection remains the treatment of choice, with an excellent prognosis. This case highlights the importance of considering MFB in the differential diagnosis of scrotal masses, even with atypical presentations.
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Affiliation(s)
- Rao E Hassan
- Orthopaedics and Trauma, Khyber Teaching Hospital Medical Teaching Institute (MTI), Peshawar, PAK
| | - Muhammad Raza
- General Surgery, Ayub Medical College, Abbottabad, PAK
| | | | | | - Johar Abbas
- General Surgery, Ayub Medical College, Abbottabad, PAK
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3
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Shaker N, Phelps R, Niedt G, Sangueza OP, Yuil-Valdes A, Untrauer J, Pradhan D. Solitary Fibrous Tumor of the Cheek: Navigating Pathology and Advanced Multivariate Risk Stratification Assessment Models: A Clinicopathologic Challenge. Am J Dermatopathol 2024; 46:542-544. [PMID: 39028120 DOI: 10.1097/dad.0000000000002701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/20/2024]
Affiliation(s)
- Nada Shaker
- Department of Pathology, The Ohio State University Wexner Medical Center/James Cancer Hospital, Columbus, OH
| | - Robert Phelps
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - George Niedt
- Departments of Dermatology and Pathology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Omar P Sangueza
- Department of Pathology and Dermatology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Ana Yuil-Valdes
- Department of Pathology and Dermatology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Jason Untrauer
- Department of Pathology and Dermatology, Wake Forest University, School of Medicine, Medical Center Boulevard, Winston-Salem, NC
| | - Dinesh Pradhan
- Department of Pathology & Microbiology, University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE
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Narasimhamurthy M, Savant D, Shreve L, Rosen MA, Lee MK, Cooper K, Furth EE, Zhang PJ, Yang Z. Myofibroblastoma in the Liver: A Case Report and Review of Literature. Int J Surg Pathol 2023; 31:1559-1564. [PMID: 36917841 PMCID: PMC10616985 DOI: 10.1177/10668969231160262] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 02/07/2023] [Accepted: 02/09/2023] [Indexed: 03/15/2023]
Abstract
Myofibroblastoma is a rare benign mesenchymal tumor first described in the breast. It is also known as mammary-type myofibroblastoma outside of the breast, more frequently located along the embryonic milk line. Exceptionally, myofibroblastoma can occur at visceral locations. We present a case of myofibroblastoma detected incidentally in the liver. A well-circumscribed mass, grossly measuring 6.2 cm in the liver parenchyma, was found on imaging studies. Histologically, the lesion is characterized by benign spindle cells in a hyalinized collagenous stroma, with positive staining for SMA and ER, focal positivity for CD34, negative for desmin, and loss of RB1. This rare tumor at such an unusual location makes it diagnostically challenging, especially on core biopsy of the lesion. To our knowledge, this is the second case of myofibroblastoma in the liver reported in the English literature and the first such case with a detailed pathology description.
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Affiliation(s)
- Mohan Narasimhamurthy
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Deepika Savant
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
- Department of Anatomic Pathology, Zucker School of Medicine at Hofstra/Northwell, Greenvale, New York, USA
| | - Lauren Shreve
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Mark A. Rosen
- Department of Radiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Major Kenneth Lee
- Department of Surgery, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Kumarasen Cooper
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Emma E. Furth
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Paul J. Zhang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Zhaohai Yang
- Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
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Zeng YF, Dai YZ, Chen M. Mammary-type myofibroblastoma with infarction and atypical mitosis-a potential diagnostic pitfall: A case report. World J Clin Cases 2022; 10:5343-5351. [PMID: 35812659 PMCID: PMC9210889 DOI: 10.12998/wjcc.v10.i16.5343] [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: 07/18/2021] [Revised: 11/04/2021] [Accepted: 04/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Mammary-type myofibroblastoma (MTMF) is a rare benign extramammary soft tissue tumor with myofibroblastic differentiation. Although 160 cases of MTMF have been reported in the literature since 2001, no cases of infarction or atypical mitosis have been reported so far. Herein, we report an unusual case of MTMF in the pelvic cavity, which mimicked some malignant features, including infarction, atypical mitosis, infiltrative growth, and prominent cytologic atypia, making it difficult to ascertain whether the tumor was benign.
CASE SUMMARY A 49-year-old man complained of pain and discomfort in the right buttock for more than 4 mo and did not receive any treatment. Nuclear magnetic resonance imaging (MRI) showed a 13-cm-sized mass in his right pelvic cavity. Histologically significant differences were atypical mitosis figures and multiple necrotic foci in the tumor. In addition, smooth muscle and skeletal muscle were invaded within and at the edge of the tumor. These morphologic features are often reminiscent of malignant tumors and therefore pose a diagnostic challenge to pathologists. The tumor cells were strongly positive for both cluster of differentiation 34 and desmin, and the loss of retinoblastoma 1 shown by immunohistochemical and fluorescence in situ hybridization results confirmed the pathological diagnosis of MTMF. Currently, the patient is alive and in good condition without tumor recurrence or metastasis after 2.5 years of follow-up by telephone and MRI.
CONCLUSION The two pseudo-malignant characteristics of infarction and atypical mitosis broaden the morphological lineage of MTMF, a rare mesenchymal tumor.
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Affiliation(s)
- Yuan-Feng Zeng
- Department of Pathology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
| | - Yan-Zhi Dai
- Department of Pathology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
| | - Min Chen
- Department of Pathology, Jiangxi Provincial People’s Hospital, The First Affiliated Hospital of Nanchang Medical College, Nanchang 330006, Jiangxi Province, China
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Akhlaq N, Purgina B, Werier J, Jibri Z. Mammary-type myofibroblastoma of the thigh mimicking liposarcoma. Skeletal Radiol 2022; 51:441-445. [PMID: 34430996 DOI: 10.1007/s00256-021-03891-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/12/2021] [Accepted: 08/13/2021] [Indexed: 02/02/2023]
Abstract
Myofibroblastoma is a rare tumor that was originally described in the breast but has since been found in extra-mammary locations, where it been renamed mammary-type myofibroblastoma (MTM). We describe a case of MTM occurring in the anterior compartment of the thigh, which was initially interpreted as a possible a liposarcoma on MRI. Two subsequent biopsy samples and eventual excision revealed the tumor to have the characteristic pathology of MTM. This benign tumor, albeit rare, needs to be considered in the imaging differential diagnosis of fat containing deep soft tissue masses of the extremity.
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Affiliation(s)
- Natasha Akhlaq
- Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Bibianna Purgina
- Department of Pathology and Laboratory Medicine, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Joel Werier
- Department of Surgery, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada
| | - Zaid Jibri
- Department of Medical Imaging, The Ottawa Hospital, 501 Smyth Road, Ottawa, ON, K1H 8L6, Canada.
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Ka K, Foba ML, Ka S, Dieng MM, Gaye PM, Dem A. [Extramammary myofibroblastoma affecting the pelvic region: a case report]. Pan Afr Med J 2021; 38:154. [PMID: 33995761 PMCID: PMC8077639 DOI: 10.11604/pamj.2021.38.154.28060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 02/03/2021] [Indexed: 11/11/2022] Open
Abstract
Un myofibroblastome de type mammaire est une tumeur molle rare; les myofibroblastomes extramammaires sont particulièrement rare. Un homme de 78 ans s'est présenté en consultation pour des douleurs pelviennes soulagées par la défécation ou les urines. Le toucher rectal retrouve une masse en avant de la paroi rectale antérieure. L'imagerie par résonance magnétique (IRM) montre une masse de 10 x 6 x 8cm, bien circonscrite et hétérogène, située en arrière de la vessie qu'elle refoule vers l'avant, en avant du recto-sigmoïde. L'immunohistochimie montre des cellules tumorales co-exprimant CD34 et la desmine de façon diffuse, expression de Rb dans la majorité des cellules, expression des récepteurs aux œstrogènes, expression intense et diffuse de la P16, un index de prolifération avec le ki67 estimé à 25%. Il n'y a pas eu de récidive après 8 mois de radiothérapie d'induction suivie de chirurgie. Un myofibroblastome de type mammaire est une tumeur rare et bénigne. La récidive n'est quasiment pas observée après traitement local. Ce cas permet de mettre en avance la possibilité d'utiliser la radiothérapie afin de faciliter la chirurgie.
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Affiliation(s)
- Kanta Ka
- Service de Radiothérapie, Centre Hospitalier National Universitaire Dalal Jamm, Guédiawaye, Sénégal
| | - Mamadou Lassana Foba
- Université Cheikh Anta Diop de Dakar, Dakar, Sénégal.,Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Sidy Ka
- Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal.,Service d'Oncologie, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Mamadou Moustapha Dieng
- Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal.,Service d'Oncologie, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Papa Macoumba Gaye
- Service de Radiothérapie, Centre Hospitalier National Universitaire Dalal Jamm, Guédiawaye, Sénégal.,Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
| | - Ahmadou Dem
- Service de Chirurgie Plastique, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal.,Service d'Oncologie, Centre Hospitalier Universitaire Aristide Le Dantec, Dakar, Sénégal
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Dimpi S, Sukrity S, Sudhir Kumar K, Imran GM, Tripti K. Extramammary orbital myofibroblastoma: a rare orbital tumor. Orbit 2020; 40:55-59. [PMID: 31935148 DOI: 10.1080/01676830.2020.1711781] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Extra-mammary myofibroblastomas are rare benign mesenchymal neoplasms, histologically and immune-phenotypically identical to mammary myofibroblastomas. Histologically, they are characterized by the abundance of spindle cells in hyalinized collagenous stroma with positive expression of CD 34 and desmin. We present an extremely rare case of extra-mammary myofibroblastoma of the orbit in a 29-year - old male who presented with painless proptosis of the right eye, with a description of clinical, radiological, and histological findings.
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Affiliation(s)
- Sinha Dimpi
- Department of Radiology, Aster CMI Hospital , Bangalore, India
| | - Sharma Sukrity
- Department of Radiology, Aster CMI Hospital , Bangalore, India
| | | | | | - Kaur Tripti
- Department of Pathology, Aster CMI Hospital , Bangalore, India
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Ishihara A, Yasuda T, Sakae Y, Sakae M, Hamada T, Tsukazaki H, Tsukazaki T, Furumoto M. A case of mammary-type myofibroblastoma of the inguinal region. Int J Surg Case Rep 2018; 53:464-467. [PMID: 30567070 PMCID: PMC6275203 DOI: 10.1016/j.ijscr.2018.11.048] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Revised: 11/10/2018] [Accepted: 11/18/2018] [Indexed: 11/30/2022] Open
Abstract
Mammary-type Myofibroblastoma of the Inguinal Region is very rare. Prognosis of this disease is good after surgical resection. The correct diagnosis and treatment is important. We think that it is useful to share knowledge widely about this disease. Introduction Myofibroblastoma is usually occurred in the breast and extra-mammary disease is rare. Presentation of case A 38-year-old man was admitted to our hospital for further examination of the left inguinal tumour, present and enlarging for 16 months. The tumor was 50 mm in diameter, well-circumscribed, firm, and painless. Ultrasonogaphy, computed tomography(CT) and magnetic resonance imaging (MRI) could not provide the definitive diagnosis. Surgical exploration confirmed a 50 mm tumour with a clear surface with a thin capsule. Complete excision was achieved. Histopathology confirmed the tumor had oval and spindle shaped fibroblastic cells with rich collagen deposition. It stained positive for ER, CD34, desmin and CD10 but negative for -smooth muscle actin and S-100. A mammary-type myofibroblastoma was diagnosed based on these results. Discussion An extra-mammary myofibroblastoma is very rare and first reported in 2001. Since then, over 160 cases have been reported. On immunohistochemistry, these lesions are characteristically positive for CD34 and desmin, with variable staining for α-smooth muscle actin. Once the diagnosis is made, regardless of size or location, this tumour behaves in a benign fashion after surgical excision reported so far. Conclusion This case is rare, but the correct diagnosis and treatment is important for good prognosis.
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Affiliation(s)
- Atsushi Ishihara
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | - Takeo Yasuda
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan.
| | - Yukari Sakae
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | - Masayuki Sakae
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | - Tooru Hamada
- Department of Surgery, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | - Hideki Tsukazaki
- Department of Urology, Tsukazaki Hospital, Himeji, 671-1227, Japan
| | | | - Masaru Furumoto
- Department of Pathology, Tsukazaki Hospital, Himeji, 671-1227, Japan
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Abstract
Mammary myofibroblastoma is a rare, benign, mesenchymal neoplasm that was first described in the breast in 1987. However, extra-mammary-type myofibroblastoma (MTMF) was not described until 2001 as a distinct entity. We report a case of extra-MTMF arising from the retroperitoneum, which was encountered in our clinic. We also completed a review of the literature using PubMed in patients with extra-MTMF.
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Affiliation(s)
- Kamran Khan
- Department of General Surgery, Sinai Center for Geriatric Surgery, Baltimore, Maryland, USA
| | - Arun A Mavanur
- Department of General Surgery, Johns Hopkins University, Baltimore, Maryland, USA Department of Surgical Oncology, Sinai Hospital, Baltimore, Maryland, USA
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Pan J, Wang S, Zhang Y, Fan Z. Mammary myofibroblastoma in the right lateral abdominal wall. World J Surg Oncol 2016; 14:55. [PMID: 26911514 PMCID: PMC4766690 DOI: 10.1186/s12957-016-0796-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2015] [Accepted: 02/16/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND A mammary-type myofibroblastoma is a rare soft tumor; extramammary myofibroblastomas are especially rare. CASE PRESENTATION A 51-year-old woman presented to our department for evaluation of a mass on the right lower abdominal wall. The mass was then excised completely. Gross examination showed a huge, well-circumscribed soft tissue mass. The pathologic diagnosis was an extramammary myofibroblastoma. There was no recurrence after excision at the 6-month follow-up visit. CONCLUSIONS A mammary-type myofibroblastoma is a benign soft tissue neoplasm. No malignant behavior and/or recurrence of mammary-type myofibroblastomas after surgical resection have been described as a function of size and location. The present case aimed to provide a possible differential diagnosis for such abdominal masses.
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Affiliation(s)
- Jiyong Pan
- Department of General Surgery, the Third People's Hospital of Dalian (Dalian Third People's Hospital Affiliated to Dalian Medical University), Dalian, 116033, China
| | - Shuang Wang
- VIP Department, Affiliated Zhongshan Hospital of Dalian University, Dalian, 116001, China
| | - Yingyi Zhang
- Department of General Surgery, the Third People's Hospital of Dalian (Dalian Third People's Hospital Affiliated to Dalian Medical University), Dalian, 116033, China
| | - Zhe Fan
- Department of General Surgery, the Third People's Hospital of Dalian (Dalian Third People's Hospital Affiliated to Dalian Medical University), Dalian, 116033, China.
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