Myofibroblastoma of the breast in postmenopausal women: Two case reports with imaging findings and review of the literature

Abstract

Myofibroblastoma is a rare benign mesenchymal tumor of the breast, which tends to affect postmenopausal women and older men. It usually presents as a unilateral, wellcircumscribed, firm, nontender, and freely mobile mass. We report two cases of myofibroblastoma in postmenopausal women with the imaging findings of mammography, ultrasonography, computed tomography, 18 F-Fluorodeoxyglucose-positron emission tomography computed tomography, and pathologic findings and review the relevant literature. K E Y W O R D S 18 F-Fluorodeoxyglucose-positron emission tomography, breast, computed tomography, mammography, myofibroblastoma, ultrasonography

Mammary Myofibroblastoma in a Male: A Case Report and Review of the Literature

“…On gross examination, MFB is a solid, defined, encapsulated tumor beside foci of mucoid and lipomatous changes. Cystic changes, hemorrhage, and necrosis are rare [ 16 ].…”

“…Features of MFB on histopathology include spindle cells in fascicles with collagen bundles, well-demarcated borders, low mitotic activity, and positive CD34 [ 2 , 3 ]. Many additional variants of MFB have been identified since the first reported cases, including collagenous, fibrous, cellular, lipomatous, infiltrative, epithelioid, myxoid, palisaded, and decidua-like variants [ 2 , 6 , 16 ]. Immunohistochemistry thus is essential to confirm the diagnosis [ 2 ].…”

Mesenchymal Tumors of the Breast: Fibroblastic/Myofibroblastic Lesions and Other Lesions

“…Myofibroblastomas have a supposed male predominance [18,21] with an association with gynaecomastia, though others have refuted the gender predilection [22]. They appear as slow-growing, solid, and mobile masses.…”

“…Generally, for a complete triple assessment, a CNB is required rather than an FNA. FNA will generally only show whorls of spindle cells that are non-specific [22].…”

“…There were no identified case reports of observation for this benign lesion; their natural history without local excision is therefore unclear [18,21]). Some have been managed by mastectomy, due to size or misdiagnosis as sarcomas [22]. Howitt reports two late (>10 years) local recurrences.…”