Spontaneous infarction of fibroadenoma of breast—A case report with literature review

Salih, Abdulwahid M.; Kakamad, Fahmi H.

doi:10.1016/j.ijscr.2016.04.040

Cited by 5 publications

(5 citation statements)

References 8 publications

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“…Intratumoral hemorrhages of solid breast tumors have been reported in breast carcinomas and phyllodes tumors, more often in malignant than in benign phyllodes tumors, and is thought to be an effect of rapid tumor growth with hemorrhagic infarction or rupture of tumoral vessels . Conversely, spontaneous hemorrhage within a fibroadenoma, which is usually hemorrhagic infarction, is a very rare complication that occurs mostly during pregnancy or lactation …”

Section: Discussionmentioning

confidence: 99%

T2-hypointense rim of breast mass lesions on magnetic resonance images: Radiologic-pathologic correlation

et al. 2018

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We investigated the radiologic-pathologic correlation of a strong hypointense rim on T2-weighted images (T2-hypo-rim) surrounding breast mass lesions and evaluated its clinical significance. We retrospectively reviewed 3503 consecutive breast magnetic resonance imaging (MRI) examinations. The T2-hypo-rim was defined as a border of strong hypointensity compared with the fat signal on fat-suppressed T2-weighted images. Detected lesions with T2-hypo-rim were classified as a solid or cystic mass with MRI and correlated with histopathologic findings. Sixty-two masses (2%; 34 solid, 28 cystic) with T2-hypo-rim were detected [44 breast cancers, 18 benign lesions, including 15 (24%) papillary tumors]. Patients with cancer were significantly older than those with benign lesions (P = .002). Breast cancers were significantly larger than benign masses (P = .023). In 49 of 62 lesions (24 solid and 16 cystic cancers; three solid and six cystic benign masses), the rims were accurately correlated with the histopathologic findings. All malignant and benign cystic masses exhibited hemosiderin deposits in the cyst walls. However, 22 of 24 solid cancers and no solid benign masses exhibited hemosiderin at the tumor periphery (92% and 0%, respectively, P < .001). In addition, a thick fibrous capsule was present in nine (38%) of 24 solid cancers and none of the solid benign lesions. Strong T2-hypo-rims mostly correlated with hemosiderin deposits and/or sometimes fibrous capsules. Although the rims could not distinguish malignant from benign cystic lesions, they indicated malignancy in solid mass lesions on MRI. Additionally, the rims often indicated papillary tumors.

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Section: Discussionmentioning

confidence: 99%

T2-hypointense rim of breast mass lesions on magnetic resonance images: Radiologic-pathologic correlation

et al. 2018

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“…The definitive diagnosis of infarct fibroadenoma is the histopathological examination in which abundant areas of ischaemic necrosis, and hemorrhage with partial or null retention of the original architecture of the fibroadenoma without inflammatory or atypical cells can be observed [1]. In our case, the histological examination showed fibroadenoma with necrotic and hemorrhagic changes.…”

Section: Discussionmentioning

confidence: 62%

“…The most common recommended investigation for breast masses is FNAC [10]. In the FNAC, microscopic features of infarcted fibroadenoma are several individually scattered round or oval cells, without atypical features, and ghostly epithelial cells in a necrotic background [1]. In our case, the absence of suspicion of malignancy and the non-resolution of the condition after antibiotic treatment led us to perform tumor removal.…”

Section: Discussionmentioning

confidence: 75%

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Infarcted Fibroadenoma of the Breast: Difficulties in Diagnosis

Bosquet¹,

Sousa²,

Rovira³

2022

SCR

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Introduction: Infarction is a very rare complication of fibroadenoma. Diagnosis of such a situation is not easy. Case Presentation: 23-year-old woman with a painful tumor of the right breast with mild erythema at the periareolar region. Breast ultrasound shows a heterogeneous lesion of 31×30 mm, in the retroareolar right breast with well-defined borders, and does not present vascular flow inside. Antibiotic treatment was administered without improvement. The breast ultrasound was repeated with no significant changes. Surgical removal of a well-encapsulated cystic lesion was performed. The patient was discharged the same day of surgery, and her postoperative evolution was correct. Histopathologic evaluation revealed an infarcted fibroadenoma. Conclusion: Breast ultrasound could be very useful in the diagnosis of infarcted fibroadenoma; treatment consists of local excision of the lesion.

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“…Therefore, ischemia/infarction-related factors may be involved in the SR of our patient's tumor. In addition, it has been reported that spontaneous infarction often occurs in benign breast lesions, including fibroadenoma, intraductal papilloma and lactating adenoma, and the most frequent clinical manifestation is a painful breast mass [16,17]. Our patient's painful breast tumor might have been due to infarction of the tumor, although the mechanism and trigger of the necrotic change were unclear.…”

Section: Discussionmentioning

confidence: 76%

Temporary spontaneous regression of male breast cancer: a case report

et al. 2020

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Background Spontaneous regression (SR) of a malignant tumor is the partial or complete disappearance of primary or metastatic tumor tissue in the absence of treatment, which can be temporary or permanent. Here, we report an extremely rare case of male breast cancer that exhibited temporary SR followed by reappearance 8 months after tumor disappearance. Case presentation A 70-year-old man presented at our hospital with a primary complaint of pain and a lump in his left breast. Ultrasonography revealed a hypoechoic lesion measuring 12 mm × 10 mm × 8 mm. Fine-needle aspiration cytology revealed numerous necrotic and degenerated cells and few sheet-like clusters of atypical ductal epithelial cells. The atypical cells had mildly enlarged nuclei with nucleoli, were focally overlapped and formed tubular patterns. The cytological diagnosis indicated a suspicion of malignancy. Core needle biopsy (CNB) revealed necrotic and degenerated cells with microcalcification. The pathological diagnosis was indeterminate because there was no area of viable atypical cells. An excisional biopsy of the left breast lesion was scheduled one month later. However, it was difficult to detect the tumor during physical examination and ultrasonography performed 1 month after the patient’s first visit. The operation was canceled, and the patient received follow-up observation. After 8 months of follow-up, ultrasonography and computed tomography (CT) revealed reappearance of a 0.6-cm-diameter breast tumor in the same place. CNB was performed again and revealed invasive ductal carcinoma. A total mastectomy with sentinel lymph node biopsy was performed 13 months after the first tumor disappeared. Histopathological examination revealed invasive cribriform carcinoma without sentinel lymph node metastasis. The patient did not have any complications, and adjuvant therapy with tamoxifen was started. The patient was alive without recurrence 7 months after surgery. Conclusions Temporary SR followed by tumor reappearance can occur in breast cancer cases, and it is important to follow patients even if their breast tumor has seemingly disappeared. When breast tumors disappear without treatment, clinicians must be aware of the possibility of SR of cancer and should follow the patient for early detection of tumor reappearance.

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Spontaneous infarction of fibroadenoma of breast—A case report with literature review

Abstract: HighlightsInfarction of breast fibroadenoma is a very rare complication.Spontaneous infarction occurs mostly during pregnancy or lactation.It poses a diagnostic dilemma of inflammatory diseases and inflammatory carcinoma due to their similarities both in clinical and cytological features.

Cited by 5 publications

References 8 publications

T2-hypointense rim of breast mass lesions on magnetic resonance images: Radiologic-pathologic correlation

T2-hypointense rim of breast mass lesions on magnetic resonance images: Radiologic-pathologic correlation

Infarcted Fibroadenoma of the Breast: Difficulties in Diagnosis

Temporary spontaneous regression of male breast cancer: a case report

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