Invasive Ductal Breast Carcinoma Underneath a Lipoma in a Male Patient

Male breast cancer is a rare malignancy and accounts for less than one percent of all cancers in men. The authors describe the case of a 76-year-old Caucasian man with invasive ductal breast carcinoma who presented with a common lipoma. This paper reviews the current literature on epidemiology, risk factors, etiology, different types of breast cancer, clinical presentation, imaging, diagnostic workup, and treatment.A 76-year-old Caucasian man presented to the authors’ clinic for evaluation of a painless lump on his left breast that had been present for six years, but recently grew over the last six months. The patient’s past medical history was significant for basal cell carcinoma, hypertension, and hypercholesterolemia, controlled with atenolol, lovastatin, and hydrochlorothiazide. The patient reported no allergies. He denied smoking, but admitted to alcohol use. Review of systems was unremarkable. Patient denied nipple retraction, discharge, or ulceration. Physical examination revealed a well-developed, well-nourished male. Upon complete skin examination, the left lower quadrant of his left breast revealed a soft, rubbery, mobile, well-circumscribed mass about 2.5x2cm in diameter. An excisional biopsy of this mass was performed, which was consistent with a lipoma. However, upon further inspection and palpation of the area, a firm mass was felt in deeper tissue. The irregular mass was about 1.2x0.8cm in diameter, very firm, and noted to have a gray color. This mass was also sent for histological examination and revealed a 0.7cm, grade II invasive ductal carcinoma with microcalcifications. The patient did not exhibit any axillary lymphadenopathy and did not have any breast discharge. There were no abnormalities or masses noted in the contralateral chest wall or contralateral axilla. Following review of the histopathology, the patient was diagnosed with breast ductal carcinoma. A computed tomography (CT) was completed of his chest and abdomen, which demonstrated no metastasis. Since his initial visit, there has been no evidence of recurrence based on mammography taken six months post-biopsy. The patient was referred to surgery for excision and oncology for further workup, including genetic testing, hormonal testing on the pathological tissue, and possibly adjunctive chemotherapy or radiation. The patient is currently under strict surveillance with regular complete cutaneous exams and mammography every six months with oncology. This case report serves to raise awareness of any growths presenting in the breasts of both male and female to exclude breast carcinoma as an underlying pathology. The authors examine the current literature surrounding male breast carcinoma.     

Axillary Metastasis as the First Manifestation of Occult Breast Cancer in a Male Patient

Summary

Background

The aim of this study was to investigate the clinicopathologic features of male breast cancer.

Case Report

We present the clinicopathologic data of a 72-year-old male patient with occult breast cancer, who was diagnosed and underwent surgery in our hospital. The diagnosis was confirmed by histological examination, and the patient underwent modified radical mastectomy and axillary dissection. The histological examination showed no tumor foci in the resected breast tissue, but 2 of 15 dissected axillary lymph nodes were invaded by infiltrating ductal carcinoma. Immunohistochemistry staining was negative for both estrogen and progesterone receptors, but showed expression of p53 protein (+++), proliferating cell nuclear antigen (PCNA) (+++), Bcl-2 on-coprotein (+++), nm23 protein (++), multidrug resistance protein (MRP) (++), and human epidermal receptor (HER-2) oncoprotein (+++). 24 months after being diagnosed, the patient is alive without any residual or metastatic disease.

Conclusions

Breast cancer is very rare in men, and the occurrence of occult breast cancer is even less common. Axillary metastases can present as the first manifestation of breast cancer in a male.Key Words: Male breast cancer, Metastasis, Pathology, Hereditary nonpolyposis colorectal cancer, HNPCC     

Male Breast Cancer Patient and Surgeon Experience: The Male WhySurg Study

Annals of Surgical Oncology - Little is known about the experience of the male breast cancer patient. Mastectomy is often offered despite evidence that breast-conserving surgery (BCS) provides...     

Palatal Soft Tissue Myxoma in a Patient with Carney Complex

Carney complex (CNC) is a rare, autosomal dominant multiple neoplasia syndrome. Although cutaneous myxomas commonly occur in CNC patients, intraoral myxomas are extremely rare. We present a case of a palatal myxoma in a 21-year-old female patient with CNC, along with a review of the pertinent literature. She presented with a sessile nodule on the hard palate that microscopically showed a multilobulated and highly vascularized myxomatous tissue composed of loosely-arranged spindle, polygonal, and stellate cells, suggestive of myxoid neurofibroma. Six years after the oral lesion was removed, she presented with a growth hormone (GH)-producing pituitary adenoma, a cardiac myxoma, two cutaneous myxomas on the lower abdomen area, and one myxoma in the vaginal mucosa. Therefore, the final diagnosis of the palatal lesion was of a soft tissue myxoma related to CNC. The patient remains on close follow-up, with no recurrences of the palatal myxoma after 7 years.     

Lobular Breast Cancer in a Male Patient with a Previous History of Irradiation Due to Hodgkin's Disease

Background

Male breast cancer is rare and represents less than 1% of all breast cancers. Considering the fact that the male breast most often does not consist of lobules and acini, lobular carcinoma of the male breast is exceptionally rare.

Case Report

In this paper we present a unique case of alveolar variant of lobular male breast cancer in a 56-year-old patient.

Conclusion

According to our knowledge this is the first presentation of an alveolar variant of lobular male breast cancer that appeared 14 years after chemo- and radiotherapy for the treatment of Hodgkin''s disease.     

Gynecomastia in a Male Hemodialysis Patient

As a result of one dramatic case, I've noted that gynecomastia is fairly common in male hemodialysis patients. Generally these patients are not receiving any medications associated with this problem. Should gynecomastia be investigated in dialysis patients? If so, when and how?     

Primary Breast Angiosarcoma in a Male

Angiosarcoma of the breast represent <1% of breast malignancies. It can arise de novo (primary) or following treatment for breast carcinoma (secondary). Primary breast angiosarcoma usually affects young women and is extremely rare in the male patient population. Imaging features can have a nonspecific appearance. Histologically, the diagnosis can be challenging, especially in small core needle biopsies. Mastectomy or wide local excision is the usual treatment for both forms of angiosarcoma. Prognosis and recurrence is worse with increasing grade of tumor. Herein, we discuss the rare occurrence of primary breast angiosarcoma in a man with history of immunodeficiency. Clinical, radiological and pathologic findings will be discussed.     

Idiopathic Prostatic Giant Calculi in a Young Male Patient

We report a case of 41-year-old man with idiopathic prostatic giant calculi presenting with voiding difficulty. To our knowledge this is the youngest case with idiopathic prostatic giant calculi reported in the literature. The etiopathogenesis of prostatic calculi are also discussed.     

Bilateral Orbital Metastases as the Presenting Finding in a Male Patient with Breast Cancer: A Case Report and Review of the Literature

Abstract: Breast cancer in men has traditionally been thought to be substantially different from that in women. As more becomes known about this relatively rare entity, the similarities between genders become more striking than the differences. Carcinoma of the male breast is an uncommon disease occurring in less than 1% of all breast cancers. Male breast carcinoma is staged similarly to female breast cancer using the American Joint Committee Clinical Staging System. As in women, axillary nodal status is the strongest predictor of outcome. Distant metastasis to bones, soft tissue, lungs, and liver have been widely reported in men with breast cancer. This case report provides a rather rare presentation of a man with breast carcinoma with bilateral orbital metastasis as an initial clinical presentation.