Metastasis to the breast from extramammary malignancies: a report of four cases and a review of literature

Breast metastases from extramammary tumours are rare with few cases reported. Four cases of metastasis to the breast are presented and the diagnostic problems of this condition are reviewed. Correlation between the histology of primary tumour and the cytology of breast metastatic tumour can avoid the surgical breast biopsy and unnecessary mastectomy. Metastasis to the breast has poor prognosis.     

Myofibroblastoma of male breast: report of three cases and review of the literature

We report three cases of male breast myofibroblastoma. This uncommon benign tumor arises from breast mesenchyma and is more frequently seen in adult men. Mammographic findings consist of a well-delimited, round to oval dense mass, variable in size but usually 1–4 cm in diameter. No microcalcifications were observed. Ultrasonography confirms the solid nature of the lesion, showing a well-circumscribed, homogeneous, hypoechoic mass, compressible with pressure. Although FNA cytology may support the diagnosis, surgical biopsy should be performed. Tumorectomy is the treatment of choice. To our knowledge, no more than 40 cases of breast myofibroblastoma have been reported. This is the first report in the literature which emphasizes the mammographic and ultrasonographic features of this tumor. Received: 30 April 1996; Revision received: 22 August 1996; Accepted: 30 September 1996     

Calcified filariasis of the breast: report of four cases

Circumscribed to endemic areas throughout tropical countries, filariasis is a rare and unknown disease in Europe. We report four cases of calcified filariasis involving the breast, supporting the diagnosis on the typical mammographic appearance of the calcified worms and the past history of filarial infection. Few reports have been published in the radiology literature about this infrequent manifestation of the parasitation. The purpose of this article is to show the mammographic characteristics of this disease that soon will be seen frequently in developed countries due to the increasing population from the endemic areas.     

Metastases to the breast: report of three cases

Metastases to the breast from extramammary malignancies are rare, but the proper diagnosis in such cases is important, because the prognosis and treatment differ from those of primary breast cancer. This is a report of the three blood-borne multinodular metastases, existing in two cases bilaterally. Preliminary preoperative diagnosis has been formed owing to discussion among clinicians, radiologists (recognition of benign masses in all cases), and pathologists (cancer or suspicious cells in all cases). It must be pointed out that in cases when mammography indicates benign changes and cytology cell cancers, especially in multinodular form, the diagnosis of metastasis must be taken into consideration. Correspondence to: K. Iwaszkiewicz     

The role of breast imaging in macrolane injection—A review and report of three cases

The demand for minimally invasive cosmetic procedures is increasing. Injectable hyaluronic acid is an effective and well tolerated procedure that can be used for breast augmentation and provides predictable long-lasting results if administered appropriately in the correct tissue plane. Concerns already exist regarding the effect of Macrolane™ on breast cancer screening, and we raise a new concern about the need for imaging for its safe administration. We present three cases referred to our centre in the last 2 years with complications associated with Macrolane™ injection, possibly from injection into an incorrect tissue plane. Complications included breast pain, haematoma, cellulitis and abscess formation. We suggest that such aesthetic procedures should be carried out under ultrasound guidance to ensure administration into the correct site, potentially avoiding such complications.     

Silicone exposure associated with breast papillary lesion: A case report

We described a breast papillary lesion related to silicone breast implant exposure. The case report is in accordance with our initial publication, where we proposed that silicone particles may trigger a process of reverse morphogenesis in pericapsular tissue resulting in metaplasia of the epithelial cells. The relationship between breast metaplasia and silicone implants is still little discussed in the literature. Our current study is based on evidence obtained from the files of a patient with a six-year-old history of silicone breast implant, which resulted in a diagnosis of a papillary lesion after a percutaneous breast biopsy. Currently, the main complications related to implants reported in the literature are intra- and extra-capsular ruptures, capsular contracture, and the most severe, breast implant-associated anaplastic large cell lymphoma. However, another complication not yet widely accepted in the literature is breast implant illness, resulting from silicone induced granuloma of breast implant capsule. Many medical specialists are skeptical about silicone disease potential and argue the lack of scientific evidence to support its existence. We believe that presenting these findings and the appropriate discussion of the results should contribute to a better understanding of the pathologies related to breast implants. It is worth mentioning that the safety of breast implants must be questioned.     

Myositis ossificans of the breast - A rare case report with radiologic-pathologic correlation

Myositis ossificans is a pathologic process of ossification in soft tissues. The breast is an exceptionally rare location for myositis ossificans with less than 5 cases documented in the English literature. We present a case of a 66-year-old woman with myositis ossificans of the left breast and no known initiating trauma. The significance of the progression of clinical and radiological findings are discussed in detail. This case shows the importance of radiology for identifying unique pathology as well as close radiological follow up.     

Dermatofibrosarcoma protuberans of the breast: a case report

Dermatofibrosarcoma protuberans (DFSP) is an uncommon mesenchymal tumour of the dermis and subcutis, which most commonly appears on the body and the extremities. Its occurrence in the breast is rare, and when it does, it can mimic a primary, benign breast lesion. We present a case of DFSP over the breast of a patient together with the associated imaging findings that can potentially help us differentiate this tumour from a primary breast lesion. The awareness of this entity allows a prompt diagnosis to be made and the disease to be properly managed.     

Primary malignant lymphoma of the breast

Primary malignant lymphoma of the breast is a rare tumor. Recently, we encountered a case of primary malignant lymphoma of the breast and present here the mammographic and ultrasonographic (US) findings with the pathology of this rare breast tumor. The patient was a 47-year-old woman with a left breast mass. Mammography showed a 3.0 × 1.5 cm, lobulated high-density mass with well-defined margins. US revealed a lobulated mass with fairly well-defined borders, hypoechoic and heterogenous internal echoes, and posterior acoustic enhancement. It was difficult to differentiate malignant lymphoma from breast carcinoma by imaging studies. This type of breast cancer should be added to a differential diagnosis when a solitary tumor is found in the breast on mammography.     

Ultrasonography of invasive lobular carcinoma of the breast: sonographic patterns and diagnostic value: report of 102 cases

The aim of this study was to define the ultrasonographic (US) features of the invasive lobular carcinoma (ILC). For this purpose, the clinical histories and the mammographic and sonographic findings observed in 102 patients affected by documented ILC were retrospectively reviewed, and the role and value of US in the diagnosis of palpable and nonpalpable breast tumors were evaluated. At US, five proven tumors were not visualized (sensitivity: 95%), while the remaining 97 showed sonographic images that are considered typically malignant: irregular heterogenic, hypoechoic irregular masses in 94 cases, which were associated with posterior shadowing in 87. The presence of only a posterior shadowing was observed in three cases. There were 16 subclinical tumors, and in two of the four in which a mammography showed an indeterminate lesion, US demonstrated a malignant pattern. All the palpable tumors that were not detected mammographically were demonstrated by US. In 13 of the 102 patients (12.7%), the correct diagnosis of malignancy was established by US. On the basis of the data obtained, it is felt that because of its sensitivity and high specificity for malignancy, US plays a very important role in the diagnosis of ILC, whenever in a patient with positive clinical findings, the mammography is negative or the mammographic features are equivocal.     

Hyperphosphatasemia: report of three cases

We report the radiographic findings in three cases of hyperphosphatasemia. Often classified as a congenital bone dysplasia, the skeletal manifestations of this disorder are diagnostic. These features simulate Paget's disease both radiographically and with respect to salient biochemical markers. Typically, presentation is at early childhood with skull deformity, refusal to weight bear, and bowing of the extremities. Notable radiographic features include bowing of the long bones, thickening of the cortex, osteopenia, coarsened trabecular pattern, expansion of the medullary cavity, and thickening of the intramembranous portion of the calvarium. Histologic features include absence of lamellar bone and haversian systems, with thick osteoid seams and increased number of osteoclasts. An autosomal recessive pattern of inheritance has been suggested, although autosomal dominant varieties have been postulated.     

乳腺癌的钼靶X线诊断（216例报告及文献复习）

目的提高钼靶X线对乳腺癌的诊断水平。方法回顾性分析了经手术病理证实的216例乳腺癌的钼靶X线表现。结果本组216例患者中，钼靶X线正确诊断180例，诊断准确率为83．33％。病变位于外上象限116例（53．70％）；清晰显示肿块者150例（69．44％），有毛刺者48例（22．22％），钙化者128例（59．26％），腺体结构紊乱、扭曲伴非对称性致密影者24例（11．11％）。结论钼靶X线摄影能很好地反映乳腺癌的病理特征，因而对乳腺癌的早期诊断与鉴别诊断有重要意义。     

130例乳腺癌彩超表现与病理相关性的研究

目的 探讨乳腺癌彩色多普勒超声与病理组织学分类的关系，并寻找其诊断要点。方法 应用高频彩色多普勒超声检查了130例乳腺癌共计136个肿块，根据其超声声像图表现从形态、边界、回声、钙化灶，与周围组织的关系、血流显像等要素对病灶的超声图像与病理结果进行回顾性分析。结果 130例乳腺癌中，超声诊断112例，误诊18例，超声与病理结果的符合率为86．15％。假阴性率13．85％。结论 对乳腺癌声像图的特征与病理检查结果对照分析有利于系统观察肿瘤组织学改变的多样性及复杂性，确诊要点以肿瘤的边界、回声特征最为关键。对恶性肿瘤滋养血管的血流特性，用彩色多普勒血流显像技术显示有助诊断。     

Metastases to the breast from extramammary malignancies – PET/CT findings

Detection of incidental malignant lesions in the breast has a significant clinical impact not only on healthy individuals but also on patients with known malignant disease. This review describes a spectrum of metastatic breast lesions incidentally detected by FDG PET-CT at staging that may be misinterpreted as second primary malignancy. The common non-mammary malignancies that metastasize to the breast include melanoma, hematopoietic malignancies and epithelial cancers. We present the FDG PET-CT features of incidental non-mammary metastases to the breast that may help distinguish primary breast cancer from metastatic disease and aid in the management of patients with a known malignancy.     

乳腺癌的钼靶X线摄影与临床触诊评价(附66例报告)

目的评价乳腺癌钼靶X线征象和临床触诊的特点,提高其诊断水平。方法回顾分析2008年12月至2010年2月在我院常规检查且经手术病理证实为乳腺癌66例患者的钼靶X线征象和临床触诊特点。结果 66例乳腺癌患者(1例为双侧),63例临床扪及包块,65例乳腺钼靶X线均显示恶性征象,其中28例可见病灶内簇状钙化。结论乳腺钼靶X线对乳腺癌的诊断有很重要的价值,优于临床触诊,但临床触诊是乳腺检查的重要步骤。     

Oesophageal haematoma: report of three cases

Three cases of intramural haematoma of the oesophagus are reported. Two cases mimicked benign neoplasms of the distal oesophagus. One of these resembled a polypoid tumour; the other occurred in a patient with known achalasia. Two cases presented with chest pain and haematemesis, the third presented with dysphagia and odynophagia only. One case was truly spontaneous and two cases were thought to be secondary to trauma from food.     

Nasal teeth: report of three cases

The ectopic eruption of the teeth into the nasal cavity is a rare phenomenon. We report cases: two involving the nasal cavity and one involving the hard palate and complicated by Aspergillus rhinitis. We describe the clinical and radiologic presentation of these cases and discuss their etiology, complications, diagnosis, and treatment.