Desmoid-type Fibromatosis of the Breast Mimicking Carcinoma

Abstract

CaseA 43-year-old female with left-sided mastodynia was referred to our department for magnetic resonance imaging (MRI). Her surgical history included an excisional biopsy of a fibroadenoma in the left breast.On MRI, no explanation for the clinical complaints could be found. However, an enhancing stellate lesion (7 mm) at 9 o'clock in the contralateral right breast was noted (Figure 1B, arrowhead). The lesion had a homogeneously low signal on T1-weighted images (Figure 1A, arrow) and rapid early enhancement with plateau kinetics on dynamic contrast imaging. There was no diffusion restriction. Because of the discrepancy between the suspicious morphological findings and the rather reassuring dynamic characteristics, further mammography and breast ultrasound evaluation were recommended.On mammography of the right breast, a focal asymmetric density with spiculated margins was seen in the superolateral quadrant (Figure 2, arrow). There were no

Bilateral breast desmoid-type fibromatosis, case report and literature review

“…DF accounts for less than 0.2% of breast tumors and therefore is not the first diagnosis considered on discovery of a breast mass ( 4 ). In addition, it shares many clinical, radiological and pathological features with breast tumors and tumor-like lesions, expanding the differential diagnosis ( 5 , 6 , 7 , 20 , 21 ). Indeed, DF can be confused with malignant lesions such as fibrosarcoma, breast adenocarcinoma and particularly spindle cell metaplastic carcinoma ( 12 , 21 ).…”

“…Skin and nipple retractions are possible ( 5 , 8 ). Its radiological features are non-specific and the mammographic and ultrasonographic appearance is often confused with a malignant process ( 6 , 8 , 21 ). Indeed, mammography usually shows a mass with spiculated, irregular borders and no calcification ( 6 , 23 ).…”

“…Its radiological features are non-specific and the mammographic and ultrasonographic appearance is often confused with a malignant process ( 6 , 8 , 21 ). Indeed, mammography usually shows a mass with spiculated, irregular borders and no calcification ( 6 , 23 ). On ultrasound, BDF appears as an irregular, hypoechoic mass with no associated adenopathy ( 5 , 6 ).…”

“…Desmoid-type fibromatosis (DF) is a locally aggressive and non-metastasizing mesenchymal tumor arising from musculoaponeurotic structures accounting for 0.03 to 0.1% of solid tumors and 3% of mesenchymal tumors (1,2). It typically occurs in young adults from 20 to 40 years old and is about twice as common in women (1,(3)(4)(5)(6). There…”

“…Desmoid-type fibromatosis (DF) is a locally aggressive and non-metastasizing mesenchymal tumor arising from musculoaponeurotic structures accounting for 0.03% to 0.1% of solid tumors and 3% of mesenchymal tumors ( 1 , 2 ). It typically occurs in young adults from 20 to 40 years old and is about twice as common in women ( 1 , 3 - 6 ). There are intra-abdominal forms, mainly associated with familial adenomatous polyposis (FAP) and extra-abdominal forms, of which breast desmoid-type fibromatosis (BDF) accounts for about 4% ( 5 , 7 , 8 ).…”