Study of clinical, imaging and pathological assessment of breast lumps: an observational study

Background: A palpable lump in a woman’s breast could be benign or malignant and it requires prompt evaluation to confirm or exclude cancer. This study aims to establish the correlation between clinical and radiological parameters for provisional diagnosis of breast lumps and the role of histopathology for final diagnosis of these breast lumps.Methods: Total 275 female patients with palpable breast lumps were included in the study, where a detailed history was recorded and clinical examination was done. All patients underwent ultrasonography of the breast along with fine needle aspiration cytology or histopathology, wherever indicated.Results: Benign breast lumps were found more commonly in 18-30 years of age group whereas malignant breast lumps were seen more commonly in the 41-60 years age group and the incidence increased with age. Fixity to skin was present in 5.1% and fixity to chest wall was present in 5.8% respectively, and all of these cases turned out to be malignant.Conclusions: Attributing factors for suspicion of malignant lumps are advanced age, fixity to surrounding structures, presence of ulceration and peau’d orange breast skin appearance. Although for confirmation of malignancy from a suspected breast lump requires either cytology or histopathology of the excised specimen.

Isolated giant plexiform neurofibroma of lower back: a rare case presentation

Plexiform neurofibroma is a rare benign tumor of the peripheral tissue cells that develops in the perineurium that is often considered pathognomonic of neurofibromatosis type 1 (NF1 or von Recklinghausen disease). They occur most frequently in the craniomaxillofacial region, rarely on back and extremities. They are extremely vascular and there is 15-20% potential for malignant transformation. A 35-year-old married female presented with painless swelling in left lower back that began at around 8 years of age. The swelling gradually increased in size. The patient reported embarrassment over the disfigurement caused by the mass. Her medical history was unremarkable and none of the relatives was known to be affected. Surgical resection of the swelling with primary closure was done. Histopathology findings were consistent with neurofibromatosis. Hereby reporting a rare case of isolated plexiform neurofibroma of lower back which was surgically cured as a perusal of rare entity. We also try to emphasize on the need of sprightful clinical diagnosis with multidisciplinary approach in the management of these type of tumors. Finally, we insist on the need of a long term clinical and radiological follow-up of these patients to assess  post resection recurrence or malignant transformation.