Fibroadenoma gigante juvenil de mama: presentación de un caso clínico / Juvenile giant fibroadenoma of the breast: presentation of a clinical case

RESUMEN El fibroadenoma gigante juvenil es un tumor de mama benigno y una variante rara de los fibroadenomas. La presentación clínica suele ser una masa tumoral unilateral, de crecimiento rápido e indolora. En este artículo presentamos el caso de un fibroadenoma gigante juvenil de 12 cm de diámetro en la mama de una niña de 13 años. Se realiza estudio radiológico e histológico de la lesión siendo categorizada como un fibroadenoma gigante juvenil por lo que se realiza tumorectomía completa con remodelación mamaria posterior. A los dos meses de seguimiento, la paciente se encuentra sin signos de recidiva, con buena situación general y a la espera de cirugía de remodelación mamaria.

ABSTRACT Juvenile giant fibroadenoma is a benign breast tumor and a rare variant of fibroadenomas. The clinical presentation is usually a painless, fast growing, unilateral tumor mass. In this article we present the case of a giant juvenile fibroadenoma of 12 cm in diameter in the breast of a 13-year-old girl. A radiological and histological study of the lesion was carried out and it was categorized as a juvenile giant fibroadenoma, so a complete lumpectomy with posterior breast remodeling was performed. After two months of follow-up, the patient is without signs of recurrence, in good general condition and waiting for the breast remodeling surgery.

Adenomioepitelioma de mama. Presentación de un caso / Adenomyoepithelioma of the breast. A case presentation

RESUMEN El adenomioepitelioma es un tumor de la mama poco frecuente, generalmente de comportamiento benigno, de histología variable, que puede simular otras lesiones epiteliales, mioepiteliales y bifásicas de la mama. Patológicamente es un desorden raro caracterizado por la proliferación simultánea de las células del epitelio ductal y células mioepiteliales. Es más común en las glándulas salivales o en la piel, raras veces es encontrado en el tejido mamario. Afecta fundamentalmente al sexo femenino, alrededor de los 50 años de edad. Clínicamente se presenta por una pequeña masa palpable que ocupa cuadrantes centrales de la mama. El tratamiento de elección es la exéresis amplia de la lesión. Es frecuente la recidiva local y en algunas ocasiones puede tener degeneración maligna. Se presentó una paciente 13 años de edad, que acudió al Servicio de Cirugía del Hospital "Dr. Mario Muñoz Monroy" , municipio Colón, provincia de Matanzas con un tumor de consistencia dura; pero no pétreo, de 8-10 cm de diámetro, en cuadrantes inferiores y región retroareolar de la mama derecha. El estudio sonográfico informó la presencia de una imagen hipoecoica, de forma oval. Se realizó exéresis de la lesión. El estudio patológico e inmunohistoquímico aportó un adenomioepitelioma de la mama. La paciente no presentó complicaciones postoperatorias. Actualmente se sigue por consulta a 7 años de la cirugía.

ABSTRACT Adenomyoepithelioma is a very rare and generally benign tumor of varying histology that can simulate other epithelial, myoepithelial and biphasic lesions of the breast. Pathologically it is rare disorder characterized by the simultaneous proliferation of ductal epithelium and myoepithelial cells. It is more common in salivary glands and in skin. Rarely found in mammal tissue, it mainly affects women, aged around 50 years, and clinically presents like a palpable mass occupying central breast quadrants. The treatment of choice is the extensive excision of the lesion. Local recidivisms is very frequent, and sometimes they could have malignant degeneration. The authors present the case of a female patient, aged 13 years, who assisted the service of Surgery of the Hospital "Dr. Mario Muñoz Monroy", municipality of Colon, province of Matanzas with a tumor of hard consistence, of 8-10 cm diameter, in lower quadrants and retro alveolar region of the right mamma. The sonographic study informed the presence of a hypoechoic, oval image. The lesion was excised. The pathological and immunohistochemical study showed a breast adenomyoepithelioma. The patient did not have post-surgery complications. Currently she is followed in consultation after seven years of the surgery.

Role of grey scalie ultrasound in benign and malignant breast lesions

To evaluate the sensitivity and specificity of ultrasound in diagnosis of benign and malignant disease in correlation with histopathological findings. A comparative study. Diagnostic Radiology Department of PNS Shifa, Karachi, from January 2000 to July 2002. Adult female patients presenting with breast lump were included. Grey-scale ultrasound was done with high frequency probe. Findings were compared with histopathology. The sensitivity and specificity was determined. Eightyfive female patients with positive clinical findings were differentiated into benign [n=45, 52.9%], intermediate [n=15, 17.6%] and malignant [n=25, 29.4%], by ultrasound examination. Only one [2.2%] benign lesion was found malignant on histopathology, 8 [32%] cases of malignant group were benign on histopathology. The sensitivity of ultrasound for malignant lesion was 95.24% and specificity was 68.75% for a benign lesion. Our results were compatible with international studies. Ultrasound of breast is very useful in evaluating breast lumps. This modality is, however, not a good screening tool. When combined with clinical evaluation and mammographic studies, a subset of patients can be identified which do not require biopsy. This will not only save the cost but will also alley the anxiety of patients

application of discriminant analysis in differentiation of fibroadenoma and ductal carcinoma of breast tissue using ultrasound velocity measurement

Ultrasound propagation velocity was measured experimentally in normal, fibroadenoma and ductal carcinoma breast tissues, in order to distinguish normal breast tissue from tumors. Materials and methods: In quantitative measurements of ultrasound velocity, 403 breast tissue images were selected, comprising 130 normal breast tissue, 130 fibroadenoma, and 143 ductal carcinoma tumors. The cases were implanted in breast tissue mimicking materials and ultrasonic images [A-mode] at 35°C were processed and evaluated. It was observed that ultrasound propagation velocity is an important factor for distinguishing in vitro specimens of fibroadenoma and ductal carcinoma from normal tissue [P-value<0.005]. Evaluation of ultrasound velocities showed that from normal breast tissue, fibroadenoma and ductal carcinoma, ultrasound velocity increases respectively. The discriminant functions of types of lesions, based on ultrasound velocity, have been formulated by discriminant analysis. The results indicate that probability of discrimination, sensitivity and specificity for tumors and normal breast tissues are 72, 60 and 100 percents at 35°C. With measuring ultrasound velocities, we can distinguish normal breast tissue of from ductal carcinoma and fibroadenoma masses [with the probability of 100%]. It is proposed that probably by measuring attenuation coefficient and ultrasound velocity on time, fibroadenoma and ductal carcinoma tumors can be differentiated well