Objectives: To describe the mammographic, sonographic, and pathologic appearance of mucocele-like lesions (MLLs) of the breast and to determine the upgrade rate following surgical excision. Methods: All patients who attended Queen Elizabeth Hospital, Hong Kong from 1 January 2008 to 31 May 2014 with core needle biopsies (CNB) and MLL as one of the final pathological diagnoses or with mucinous material found within the specimens were identified. All available breast imaging, and pathology slides and reports were reviewed by radiologists and a pathologist specialised in breast imaging, respectively. The upgrade rate of MLL to high-risk lesion or to malignancy was obtained. Results: Twelve patients had either MLL or mucinous material within their CNB specimen. Their mean age was 47 years (range, 31-77 years). The most common mammographic finding was grouped coarse heterogeneous calcifications (56%) and the most observed feature on ultrasound was lesions containing cystic components (71%). Of the 12 patients, six subsequently underwent excisional biopsy of their lesion. One of them had atypia shown on CNB and a final surgical specimen revealing MLL associated with ductal carcinoma in-situ. Of the five patients with CNB showing no atypia, three (60%) were upgraded-upgraded histology included one nodenegative papillary carcinoma with foci of mucinous carcinoma and two with high-risk histology of atypical ductal hyperplasia. Conclusion: MLLs of the breast have variable mammographic and sonographic appearances but the common radiological findings include presence of grouped heterogeneous calcifications mammographically and lesions containing cystic components sonographically. A significant proportion of lesions that yielded mucinous material or that were diagnosed as a MLL on percutaneous CNB without atypia were upgraded. Surgical excision is still warranted following a CNB diagnosis of MLL to allow evaluation of the entire area and to exclude the presence of atypia or carcinoma.

With an increasing number of women undergoing breast augmentation and later presenting with breast symptoms, radiologists need to be familiar with the different imaging appearances. Mammography and ultrasonography is one of the first steps in the diagnostic workup of a woman who presents with breast symptoms. In the absence of typical features of implant rupture, however, further evaluation with magnetic resonance imaging is often necessary to determine implant integrity and complications or to detect a possibly malignant lesion.

Head injury is common and can be associated with significant morbidity and mortality. We report a 71-year-old man with typical imaging findings of depressed skull fracture on plain film and computed tomography with images in multi-planar reformat and 3-dimensional volume rendering technique, followed by a brief review of the literature.

Epidermal inclusion cyst is a common cutaneous condition. However, epidermal cyst deep in the breast parenchyma is rare. Diagnosis can be difficult if there is no suspicious clinical history. An onion-ring appearance on ultrasonography with alternating concentric hyperechoic and hypoechoic rings has been described, corresponding to the laminated keratin. Biopsy should be performed if clinically indicated. We report a case of breast epidermal cyst in a Chinese woman.