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Sung, Kim, and Bae: Unusual Ultrasonography Findings of Recurred Mammary Fibromatosis Mimicking Subareolar Mastitis: A Case Report
Breast Radiology
Case Report

Journal of the Korean Society of Radiology 2016; 75(3): 208-213.

Published online: 18 August 2016

DOI: https://doi.org/10.3348/jksr.2016.75.3.208

Unusual Ultrasonography Findings of Recurred Mammary Fibromatosis Mimicking Subareolar Mastitis: A Case Report

Hwa Sung Sung, MD1, Young-Seon Kim, MD1, Young Kyung Bae, MD2

1Department of Radiology, College of Medicine, Yeungnam University, Daegu, Korea.

2Department of Pathology, College of Medicine, Yeungnam University, Daegu, Korea.

Corresponding author: Young-Seon Kim, MD. Department of Radiology, College of Medicine, Yeungnam University, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, Korea. Tel. 82-53-620-4129, Fax. 82-53-653-5484, ing29@hanmail.net

Received 18 June 2016       Revised 30 June 2016       Accepted 3 July 2016

Copyright © 2016 The Korean Society of Radiology

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Fibromatosis, also known as an extra-abdominal desmoid tumor, rarely occurs in the breast and is often mistaken for carcinoma, clinically and radiologically. Desmoid tumor is a monoclonal myofibroblastic neoplasm which is locally aggressive, but rarely metastasizes. We herein report a case of a 64-year-old woman who experienced two episodes of recurrence of mammary fibromatosis. The mass was initially detected by screening mammography. It appeared as an irregularly shaped mass which was confined within the mammary zone. Recurrences were excised from the right breast 10 and 17 months later. The second recurrence occurred in the subareolar area accompanied by skin thickening and showed an anechoic component on ultrasonography, which mimicked subareolar mastitis with an abscess.

Keywords: Breast, Fibroma, Mastitis, Ultrasonography, Mammography

Figures and Tables

Fig. 1

Radiologic and pathologic findings of recurred mammary fibromatosis in a 64-year-old woman.

A, B. Initial presentation of mammary fibromatosis (17 months ago). Craniocaudal (A) and mediolateral oblique views (B) of the Rt. breast show an irregularly shaped, high density mass (arrows) in the subareolar area, confined within the mammary zone. Retraction of the nipple is also seen.
C. Ultrasonography demonstrates an irregularly shaped, hypoechoic mass with an indistinct margin in the mammary zone of the right subareolar area.
D, E. Radiologic findings of recurred mammary fibromatosis. Craniocaudal (D) and mediolateral oblique views (E) of the Rt. breast show an oval shaped, high density mass (white arrowheads) in the subareolar area with retraction of the nipple and thickening of the overlying skin (white arrow). Calcifications are not seen.
F. Ultrasonography of the right breast shows a 1.3 × 0.9 cm sized irregularly shaped mass in the subcutaneous fat layer of the subareolar area.
Note, the tubular shaped hypoechoic lesion between the mass and the nipple (white arrows). Increased echogenicity of the surrounding fat tissue and thickening of the overlying skin are also noted.
G. Internal vascularity is not observed on color Doppler imaging, but increased vascularity of the surrounding fat tissue and skin is seen.
H-K. Photomicrographs of an excised specimen showing fibromatosis.
(H) The lesion infiltrates the surrounding breast tissue (H&E, × 40), and (I) the hypercellular peripheral portion shows entrapped fat cells. Proliferation consists of spindle-shaped cells with little or mild cytologic atypia (H&E, × 200).
J. The central hypocellular area shows bland cytologic features (H&E, × 200).
K. Immunohistochemistry of the excised specimen. The spindle-shaped cells show nuclear and cytoplasmic positivity for beta-catenin immunostain (all × 200).
H&E = hematoxylin and eosin
jksr-75-208-g001

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