Intracystic carcinoma of the male breast: report of a case.

We experienced a very rare case of male intracystic breast carcinoma. A 66-year-old man presented at our hospital because of a palpable mass in his right breast. The imaging diagnosis was an intracystic carcinoma with hemorrhagic fluid and two mural nodules. Modified radical mastectomy was performed under general anesthesia. The pathological examination revealed the intracystic papillary carcinoma with foci of microinvasion. The findings of power Doppler ultrasonography and dynamic magnetic resonance imaging were very useful for the differential diagnosis of our case.

Angiomyofibroblastoma of the vulva: report of a case.

A 45-year-old woman was first seen by us 2 years after becoming aware of a slightly painful subcutaneous mass in her left vulva. The mass was 7.5 x 3.0 cm in size, well circumscribed, mobile, and rubbery. It was at first clinically considered to be a benign tumor. Microscopically, the resected mass was composed of spindle or polygonal tumor cells which were cellularly or hypocellularly arranged with perivascular accentuation in a mucoid or fibrocollagenous background. Immunohistochemically, myxoid tumor cells were positive for vimentin but not for alpha-smooth muscle actin, CD34, CD31, desmin, or S-100 protein. The tumor was diagnosed as an angiomyofibroblastoma (AMBF), based on the typical findings of histology and immunohistochemistry. There are many histological types of vulvar tumors, and establishing a preoperative diagnosis is difficult in many patients. Rapid intraoperative pathological diagnosis should be performed if possible, considering the possibility of diseases such as AMFB and aggressive angiomyxoma (AAM). When AAM is suspected, the peripheral tissues should also be resected to prevent recurrence.

Breast-conservation treatment for patients with ductal carcinoma in situ.

Fourteen cases with symptomatic ductal carcinoma in situ (DCIS) were treated with breast-conservation treatment intensified with endocrine therapy. Nine of 14 patients with palpable mass had tumor detected on mammography. CT, ultrasonography, and MRI were able to detect linear and/or spotty lesion or enhancement suggesting DCIS. Whereas these findings were not particular to DCIS, the combination of these modalities would be useful in deciding the extent of resection for DCIS. There was no patient selection for breast-conservation treatment in our department. All patients received tangential and boost radiation, and were treated with endocrine therapy using anti-estrogen drugs. The reason that nine cases had close margins (<5 mm) might be on account of the treatment including lumpectomy with 1 cm of surgical margin. In spite of their margin status, no local or systemic failure was experienced, and the cosmetic results of most patients were rated as excellent or good. Therefore, our breast-conservation treatment intensified with systemic therapy is thought to be adequate for patients with symptomatic DCIS. Six of eight cases who received preoperative treatment containing endocrine therapy with or without CAF chemotherapy showed a decrease in tumor size. Preoperative treatment may effect the microinvasion and/or breast tissue surrounding a DCIS tumor.

Stromal sarcoma of the breast with lung metastasis successfully treated by radiotherapy: report of a case.

We report herein the case of a 42-year-old woman in whom a solitary lung metastasis from stromal sarcoma of the breast was effectively treated by radiotherapy. The original breast tumor had been extirpated in a local hospital, and she was subsequently referred to our outpatient clinic for nonsurgical treatment. Pathological examination of the breast tumor had confirmed a diagnosis of stromal sarcoma. Radiation and systemic chemotherapy for the remnant disease were administered at our hospital; however, 8 months later, local recurrence and a solitary lung metastasis were recognized on a chest X-ray. A second lumpectomy of the recurrent breast tumor along with radiation for the lung metastasis and systemic chemotherapy were performed. After a 4-year disease-free period, there is still no sign of recurrence. This case serves to demonstrate the effectiveness of radiotherapy for the treatment of lung metastasis from stromal sarcoma of the breast.

Rapid growing fibroadenoma in an adolescent.

INTRODUCTION: We report a case of rapidly growing fibroadenoma. PATIENT: A 13-year-old girl consulted the outpatient clinic regarding a left breast mass. The mass was diagnosed as fibroadenoma by clinical examinations, and the patient was carefully monitored. The mass enlarged rapidly with each menses and showed a 50% increase in volume four months later. Lumpectomy was performed. The tumor was histologically diagnosed as fibroadenoma organized type and many glandular epithelial cells had positive immunohistochemical staining for anti-estrogen receptor antibody in the nuclei. CONCLUSION: The estrogen sensitivity of the tumor could account for the rapid growth.