1/126. Myofibroblastoma of the breast with diverse histological features.We report two cases of myofibroblastoma with unusual pathological features, in a 66-year-old woman and a 49-year-old man. Both tumours were unilateral, grossly nodular and well circumscribed, but not encapsulated. The lesions were made up of bipolar spindle cells arranged in fascicular clusters separated by bands of hialinized collagen; one included several islands of mature cartilage next to fat cells. The other contained atypical mononucleated and multinucleated giant cells. No mitotic figures were observed. Immunohistochemically, both tumours showed strong and diffuse cytoplasmic staining for vimentin and CD 34 and focal positivity for alpha-smooth muscle actin, and both were negative for cytokeratins, CD 68, Ham 5, 6, Mac 387, and S-100 protein. desmin was positive in one case. Ultrastructural study revealed populations composed of fibroblastic cells without signs of myofibroblastic differentiation in one case; the second featured abundant undifferentiated mesenchymal cells with myofibroblastic differentiation. Both patients remain disease-free 38 and 36 months after lumpectomy.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
2/126. Granulomatous reaction to silicone in axillary lymph nodes. A case report with cytologic findings.BACKGROUND: Silicone lymphadenopathy is a rare complication in patients with breast implants and is often confused with metastases from breast carcinoma. CASE: A 36-year-old female who had undergone bilateral breast augmentation six years earlier was referred for a mass in the left axilla. Fine needle aspiration showed a granulomatous reaction to birefringent material with predominance of foreign body giant cells in a lymphoid background. CONCLUSION: This report illustrates the usefulness of fine needle aspiration in axillary nodes of patients with breast implants in ruling out malignancy and diagnosing implant disruption.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
3/126. Florid juvenile (cellular) fibroadenomatosis in the adolescent: a case for subcutaneous mastectomy?Juvenile or giant fibroadenoma (JF) is an uncommon fibroadenoma variant usually presenting in adolescence. Although these masses are benign, when multiple and bilateral, they present a complex challenge to the attending surgeon, both in diagnosis, and in selection of the most appropriate therapy. Treatment is usually surgical and ranges from simple excision to subcutaneous mastectomy with reconstruction. We report an unusual case of refractory JF, initially treated with combined hormonal and surgical treatment but ultimately requiring bilateral subcutaneous mastectomies to prevent tumor regrowth. This case highlights the occasional difficulty in the management of macromastia in the adolescent female.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
4/126. Giant cellular blue nevus of the anterior chest wall mimicking metastatic melanoma to the breast: a case report.BACKGROUND AND OBJECTIVES: Blue nevi are benign pigmented dermal lesions that can mimic cutaneous melanoma in appearance. Cellular components may infiltrate subcutaneous tissue. We present a complex case of cellular blue nevus (CBN) to demonstrate the ambiguous clinical appearance of these lesions and to provide an approach for management of such cases. methods: We report an extraordinary case of CBN mimicking metastatic melanoma to the breast. A 53-year-old female with an acquired giant blue nevus of the chest wall was found to have two new breast nodules suspicious for malignancy on routine mammography. These were biopsied and interpreted as consistent with metastatic melanoma vs. CBN. The patient underwent complete excision of the chest wall nevus and modified radical mastectomy. RESULTS: Pathologic evaluation of the chest wall specimen revealed numerous collections of deeply pigmented melanocytes scattered throughout the breast parenchyma and embracing ductal structures. No mitoses or nuclear polymorphism were seen. The diagnosis of CBN involving the chest, breast tissue and axillary lymph nodes was made. CONCLUSION: Giant blue nevi overlying the breast can develop cellular components that infiltrate subcutaneous and breast tissue resulting in the appearance of breast nodules on mammography. A generous excision biopsy inclusive of the overlying nevus and breast component may be required to establish the dignity of the lesion.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
5/126. Unilateral virginal breast hypertrophy.A case of unilateral virginal breast hypertrophy with a review of the etiological factors and treatment modalities is presented. A 16-year-old girl presented with progressive enlargement of the left breast of 5 months' duration. The result of the mammographic examination was consistent with cystosarcoma phyllodes. Fine-needle aspiration biopsy revealed giant fibroadenoma. Although some of the characteristics of the fine-needle aspiration biopsy specimen were suspicious for cystosarcoma phyllodes, there were no adequate epithelial structures, which are obligatory for the diagnosis. The patient was treated with subcutaneous mastectomy and subpectoral insertion of a silicone gel implant. The histopathological examination was consistent with virginal hypertrophy. The breast maintained its volume with no further growth in the affected or in the normal breast after 4 years of follow-up.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
6/126. Delayed infection of a lymphocele following mastectomy with immediate breast reconstruction: report of a case.We report herein a rare case of delayed infection of a lymphocele following mastectomy with immediate breast reconstruction. A 38-year-old woman presented to our hospital 7 months after undergoing a left-modified radical mastectomy with an immediate breast reconstruction, following the sudden development of a giant mass in the left thoracoabdominal region as well as a high fever and shivering. ultrasonography and a computed tomographic scan revealed massive fluid retention extending from the left axilla to the lower abdominal region. Puncture drainage was performed three times and the injection of an antibiotic directly into the cyst resulted in resolution of the fluid. This massive retraction of fluid was considered to have resulted from a delayed infection of an axillary lymphocele.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
7/126. Natural skin reduction and breast recovery using a tissue expander after enucleation of a giant breast tumour.We report a new use of the tissue expander for reshaping a breast after resection of a giant tumour. After resection of giant fibroadenomas, two patients had expanders inserted into the tissue defect and gradually reduced in size over five months. This facilitated healing and natural skin shrinkage and resulted in a natural shape and size.- - - - - - - - - - ranking = 6keywords = giant (Clic here for more details about this article) |
8/126. Case of the Month. Giant multiple intraductal papilloma of the breast: a case report and review of the literature.A case is described of multiple intraductal papilloma of the breast in a 39 year old Micronesian female who presented to our institution with a 2 year history of spontaneous bloody nipple discharge with an associated giant cystic breast mass. This case report illustrates an unusual presentation of a rare benign breast lesion. The clinical, radiographic, and pathologic features of this disease process are discussed; the literature is reviewed; and management options are discussed.- - - - - - - - - - ranking = 1keywords = giant (Clic here for more details about this article) |
9/126. 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) |
10/126. Bilateral infiltrating lobular carcinoma of the breast with osteoclast-like giant cells.A case of bilateral infiltrating lobular carcinoma of the breast containing osteoclast-like giant cells is presented. Notable pathologic features include prominent tumor-associated angiogenesis and the presence of osteoclast-like giant cells in axillary lymph node metastases. Immunohistologic and ultrastructural examination support a nonepithelial, histiocytic origin for the giant cells, and results are similar to previous reports of osteoclast-like giant cells associated with breast carcinoma. This is the first report of bilateral pure infiltrating lobular carcinoma of the breast with osteoclast-like giant cells and the first case of pure lobular carcinoma with osteoclast-like giant cells present in lymph node metastases.- - - - - - - - - - ranking = 10keywords = giant (Clic here for more details about this article) |
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