1/38. The clinical, histologic, and ultrastructural presentation of polyvinyl sponge (Ivalon) breast prostheses removed for massive fluid accumulation.The current study describes what we believe is the first report of bilateral massive seromas associated with open-cell Ivalon sponges. Additionally, the gross, histologic, and ultrastructural features consistent with previous reports of polyvinyl alcohol prostheses are presented. Despite the reported chemical inertness of polyvinyl alcohol, this material may incite a biologic response in some patients, leading to dense fibrosis and occasional foreign-body giant-cell reaction. It is postulated that the molecular breakdown products of the polyvinyl alcohol polymer may create an osmotic gradient across the periprosthetic capsule, which may lead to intracapsular fluid accumulation, as presented in this case.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/38. Periarteritis nodosa presenting as a breast lesion: report of a case and review of the literature.We describe a 34-year-old woman with periarteritis nodosa (PAN) presenting as a breast lesion. Localized involvement of the breast is an unusual manifestation of PAN. To date, 10 cases have been reported: all were in women with an age range of 45-78 years (mean 63). In most cases, breast lesions were an isolated finding, and the prognosis was favourable, setting them apart from the more common form of systemic PAN. The case presented is unusual in that vasculitis developed in the postpartum period, and was associated with cutaneous PAN-like lesions elsewhere on the body, and digital artery occlusion. The most important differential diagnoses of PAN of the breast are infectious mastitis, mammary malignancy and other forms of idiopathic vasculitides of the breast, e.g. giant cell arteritis and wegener granulomatosis.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/38. A giant vascular hamartoma of the breast in a child.Vascular tumors of the breast are uncommon. Perilobular hemangiomas, the commonest histologic subtype of breast hemangiomas, constitute majority of microscopic, vascular mammary tumors. Macroscopic hemangiomas and vascular hamartomas of the breast are distinctly rare. We describe a giant, vascular hamartoma of the right breast in a five year old girl and discuss pertinent literature.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
4/38. Giant-sized condyloma of the breast with focal acantholytic changes.BACKGROUND: A healthy 26-year-old pregnant woman presented with a 6.0-cm exophytic mass in her left inframammary fold. The lesion was surgically excised. methods: Histopathologic sections of the skin lesion were reviewed in hematoxylin and eosin-stained slides. Additional sections were studied by an in situ hybridization method for human papillomavirus dna (HPV) types 6 and 11. RESULTS: The histopathologic examination demonstrated a benign exophytic, verrucous and papillary epidermal proliferation with features of condyloma acuminatum. Reactivity to HPV dna types 6 and 11 was demonstrated by in situ hybridization method. The epidermis adjacent to, and focally within, the neoplasm showed multiple areas of suprabasilar and intraepidermal acantholysis without dyskeratosis. CONCLUSIONS: Condylomas related to HPV 6 and 11 may be found in extragenital locations including conjunctiva, oral and nasal mucosa. To our knowledge, however, the extragenital condylomas described in the literature have not included the giant-sized variant. We describe an example of a benign, giant-sized condyloma acuminatum of the breast with nearby acantholytic alterations similar to Hailey-Hailey disease.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
5/38. systemic vasculitis presenting as a tumorlike lesion. Four case reports and an analysis of 79 reported cases.systemic vasculitis might present as a tumorlike lesion that initially could misdirect the correct diagnosis and the appropriate medical treatment. The aim of the present study is to summarize all reported cases of tumorlike presentation in systemic vasculitides, in order to have comprehensive data on the characteristics of this unusual phenomenon. We report 4 cases of systemic vasculitis presenting as a tumorlike lesion. In addition, we performed a medline search of all English-language papers published from 1966 to 1999, looking for vasculitis presenting as tumorlike lesion. Details were included concerning vasculitis classification, specific characteristics, location of the "tumor," the presence or absence of systemic involvement, and whether surgery was performed before diagnosis. Seventy-nine cases of vasculitis presenting as a tumorlike lesion were found in the literature, in addition to the 4 new cases described. The average age of the reported cases was 50.5 /- 15.8 years, and 51% were female. In 82% of the cases the "tumor" was associated with constitutional symptoms and elevated erythrocyte sedimentation rate (ESR). The most common vasculitis categories with tumorlike presentation were wegener granulomatosis (WG; 28 cases) and giant cell arteritis (GCA; 17 cases). In almost half the patients, surgery was performed before diagnosis. All patients with GCA presented with either a breast or an ovarian tumor. The most common location of a tumorlike lesion was the breast (22%), followed by central nervous system lesions (16%). Other frequent locations were the ovary (10%), caused exclusively by GCA and polyarteritis nodosa (PAN), and the male genitourinary system, almost all caused by PAN. Including vasculitis in the differential diagnosis of a tumorlike lesion might lead to an earlier diagnosis and consequently to prompt and appropriate treatment, avoiding needless operations. Constitutional symptoms and elevated ESR should alert clinicians to the possible diagnosis of vasculitis rather than a tumor. The association of GCA with ovarian pseudotumor is distinct and has not been emphasized before. We therefore suggest that GCA should be included in the list of differential diagnosis of an ovarian or breast tumor in an elderly woman, particularly when systemic symptoms and parameters of inflammation are present.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/38. Two cases of cholesterol granuloma of the breast.We report two cases of cholesterol granuloma of the breast clinically diagnosed as malignant and describe the features. The first patient was a 74-year-old woman who complained of a lump in the left breast. The mammography and ultrasonography suggested a malignant mass. Fine needle aspiration showed multinucleated giant cells. We suspected breast cancer, but cholesterol granuloma was diagnosed on excisional biopsy. The second case was a 51-year-old woman who was found to have a breast tumor on a screening mammography. The mammography and ultrasonography suggested carcinoma, but excisional biopsy revealed cholesterol granuloma. Reports of cholesterol granuloma of the breast are very rare. cholesterol granuloma should be considered in the differential diagnosis of breast carcinoma.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/38. Giant hamartoma of the breast.hamartoma of the breast is a rare clinico-pathologic entity. Its clinical diagnosis can be extremely difficult; however, diagnosis is not difficult when it is made on the basis of a combination of radiologic and pathologic features. Its differential diagnosis includes a circumscribed fibrocystic mass, fibroadenoma, lipoma, cystosarcoma phylloides, and various carcinomas. A high index of suspicion is mandatory. In this study, we report a case of giant hamartoma of the breast in a young postlactational female patient, including treatment of the tumor by excisional biopsy and correction of the resulting breast deformity by mastopexy. Clinical, radiologic, and pathologic features are discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
8/38. Giant mammary hamartoma diagnosed by stereomicroscopic analysis of the mammary glandular tree in an adolescent girl: report of a case.This report describes a rare case of a giant hamartoma that developed in the right breast of a 17-year-old girl. No abnormalities were found by endocrinological studies and a well-circumscribed tumor, approximately 20 cm in diameter, was easily enucleated without bleeding during surgery, following which the bilateral breasts became nearly symmetrical. Histologic features revealed predominant fibrous stroma and scattered normal or occasionally dysplastic mammary glands without neoplastic properties. No distorted lobular structures indicating fibroadenoma characteristics were observed. Subgross and stereomicroscopic analysis of serial 2-mm-thick sections revealed mature normal lobules and predominant fibrous interstitial components. Therefore, the tumor was diagnosed as a giant hamartoma of the breast, according to the histologically non-neoplastic features and the delimited macroscopic appearance. This is a rare mammary gland disease characterized by the fact that although each of the histological components seemed to be normal, their constitution was abnormal. It appears that not only histological features but also clinical details are indispensable for the diagnosis of this disease.- - - - - - - - - - ranking = 2keywords = giant (Clic here for more details about this article) |
9/38. Reduction mammaplasty in the surgical management of a giant breast hamartoma: case report.INTRODUCTION: Hamartomas of the breast can achieve unusually large proportions, causing gross distortion of the breast. Conclusive preoperative diagnosis can be difficult. We present such a case and describe the application of reduction mammaplasty techniques in the removal of such a tumour. CLINICAL PICTURE: A 39-year-old woman presented with gross enlargement of the right breast, which had developed over the course of many years. Clinically, there was no discrete mass within the breast and no palpable lymphadenopathy. TREATMENT: She underwent unilateral reduction mammaplasty. Intraoperative findings were that of a giant hamartoma. The tumour was removed and the breast reconstructed using an inferior pedicled reduction mammaplasty. OUTCOME: The resultant right breast was of a good match to the contralateral normal breast, both in size and shape. CONCLUSION: Reduction mammaplasty is a useful technique for the surgical management of giant breast hamartomas, as it not only addresses the issue of tumour removal but also the aesthetic reconstruction of the breast.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
10/38. An acquired giant vascular tumour of the breast.We present a rare case of an acquired giant vascular tumour of the breast that was diagnosed as angiomatosis. It was characterised by the mixture of blood-filled haemangiomatous, and apparently empty lymphangiomatous, vascular channels. The breast remnant returned to a normal configuration and contour without breast reduction.- - - - - - - - - - ranking = 5keywords = giant (Clic here for more details about this article) |
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