Imaging Findings of Soft Fibroma of the Nipple: Two Case Reports

Bora Im; Woon-Ju Park; Sang Wook Kim; Kye-Won Kwon; Eun Mee Han

doi:10.3348/jksr.2018.79.3.123

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Im, Park, Kim, Kwon, and Han: Imaging Findings of Soft Fibroma of the Nipple: Two Case Reports

Case Report

J Korean Soc Radiol 2018;79(3):123-128.

Published online: 19 January 2018

DOI: https://doi.org/10.3348/jksr.2018.79.3.123

Imaging Findings of Soft Fibroma of the Nipple: Two Case Reports

Bora Im, MD¹, Woon-Ju Park, MD^1,, Sang Wook Kim, MD², Kye-Won Kwon, MD³, Eun Mee Han, MD³

¹Department of Radiology, Daejin Medical Center Bundang Jesaeng General Hospital, Seongnam, Korea

²Department of General Surgery, Daejin Medical Center Bundang Jesaeng General Hospital, Seongnam, Korea

³Department of Pathology, Daejin Medical Center Bundang Jesaeng General Hospital, Seongnam, Korea

^∗Corresponding author: Woon-Ju Park, MD Department of Radiology, Daejin Medical Center Bundang Jesaeng General Hospital, 29 Seohyeon-ro 180beon-gil, Bundang-gu, Seongnam 13590, Korea. Tel. 82-31-779-0000 Fax. 82-31-779-0062 E-mail: woonju@dmc.or.kr

Received 30 January 2018 Revised 23 March 2018 Accepted 7 May 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Soft fibromas are benign skin lesions that primarily occur in the neck, axillae, and groin locations. The occurrence of soft fibroma lesions in the nipple is extremely rare. Herein, we present two cases of soft fibroma of the nipple, which occurred in a 51-year-old woman (Case 1) and a 32-year-old woman (Case 2). The mammographic and ultrasonographic features of each case are described in this report. Mammography revealed an oval-shaped isodense mass in Case 1 and an irregular-shaped isodense mass in Case 2. On ultrasonography, Case 1 showed an oval-shaped hypoechoic mass with increased vascularity, whereas Case 2 presented a microlobulated, irregular-shaped, iso- to hypo-echoic mass with subtly increased vascularity at the stalk. In both cases, surgical excision was performed and pathological examination revealed soft fibroma.

Keywords: Breast, Nipples, Fibroma, Mammography, Ultrasonography

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Fig. 1

A 51-year-old female patient with a soft fibroma in the right nipple (Case 1). A. Left panel shows a polypoid protuberance on a right nipple, approximately 0.5 cm in size. The lesion is brownish in appearance and shows a reddish discoloration that could have preceded bleeding (arrow). Right panel shows a microscopic image of a polypoid lesion with mild acanthosis of an epidermal lining and loosely arranged fibrocollagenous stroma (hematoxylin and eosin staining, × 40). B. Mammographic CC view image and MLO view image show an exophytic isodense mass (arrows) in the right nipple without microcalcification. C. Ultrasonographic images show a circumscribed, oval-shaped hypoechoic mass 0.6 × 0.4 cm in size (arrowheads) in the right nipple. The mass shows hypervascularity on the color Doppler image. CC = craniocaudal, MLO = mediolateral oblique

Fig. 2

A 32-year-old female patient with a soft fibroma in the right nipple (Case 2). A. Left upper panel shows a brown-colored and multi-lobulated mass, approximately 2 cm in size, with a short pedicle (arrow). Right upper panel is a microscopic image that shows a furrowed mass with loosely arranged collagen fibers (hematoxylin and eosin staining, × 12.5). The panel below shows mild hyperkeratosis, papillomatosis, and acanthosis of the epidermis (open arrow) (hematoxylin and eosin staining, × 40). B. Mammographic CC view image and MLO view image show an irregular-shaped isodense mass (arrows) with a cauliflower-like appearance in the right nipple without microcalcification. C. Ultrasonographic images show a microlobulated, irregular-shaped, and iso- to hypoechoic mass, measuring 1.7 × 1.5 cm in size (arrowheads), with posterior shadowing on the ultrasonography gray scale image. The mass shows slightly increased vascularity at the stalk on the color Doppler image. CC = craniocaudal, MLO = mediolateral oblique

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