Résumé
Breast cancer is the most common cause of metastatic deposits in the skeleton, and bone is the most common site of recurrence of breast cancer. Breast cancer metastasis most commonly affects the spine, ribs, pelvis, and proximal long bones; however, only 3.5% of breast cancer patients develop long-bone metastases. The humerus is the most common upper-extremity site for bony metastasis, and pathologic fractures can result. The patient in the current study presented with breast cancer and discovered to have humeral head metastasis during initial workup. The dilemma was in investigation the modality to confirm humeral head metastasis as there are many differential diagnoses with similar findings. After staging workup, the patient was treated with neoadjuvant chemotherapy followed by modified radical mastectomy and radiotherapy of the chest wall and the shoulder. The lesion in humerus was well healed.
Résumé
Pseudoangiomatous stromal hyperplasia [PASH] is a rare proliferative breast disease. It is characterized by fibrosis of the mammary stroma surrounding breast ducts and lobules with formation of anatomizing capillary-like spaces lined by myofibroblastic cells. Commonly, patients present with a palpable breast mass or continuous breast enlargement. We report a case of a 25 year old lady who presented with painless unilateral swelling of her right breast. Ultrasonography showed heterogeneous, hypoechoic benign appearing breast tissue. Histopathology revealed dense collagenous stroma separated by slit like spaces that were lined by bland spindle cells showing no cytological atypia. With immunohistochemistry, these cells were positive for CD-34 and SMA and negative for the endothelial marker CD-31. Some of these cells were also positive for ER and PR.