Silicone Breast Implant Rupture From Pectoralis Muscle Contraction Causing IgA Nephropathy: A Case Report.

A 34-year-old woman who was diagnosed with a left breast carcinoma underwent breast conserving surgery and axillary dissection. This was followed with adjuvant breast irradiation and endocrine therapy. She had a local recurrence in the breast 7 years later. She underwent a left nipple sparing mastectomy and submuscular implant reconstruction. The silicone implant ruptured during an episode of strong pectoralis muscle contraction, 5 years postimplantation. MRI confirmed the rupture to be intracapsular and extracapsular. She declined implant replacement. She presented with painless hematuria 2.5 years after the rupture. A renal biopsy confirmed IgA nephropathy.

The follow-up of post-mastectomy patients: Should the ipsilateral side be assessed with both mammogram and ultrasound?

Aim: This study aimed to determine findings of axillary view mammogram (MMG) and ultrasound (USG) of the ipsilateral side in post-mastectomy patients and to document difficulty level in performing the axillary view and patients’ pain level during the procedure. Methods: Post-mastectomy patients who had MMG and USG on follow-up during an 18-months period were included. The MMG and USG findings of 183 patients were reviewed and histology results were recorded when available. Radiographers’ difficulty and patients’ pain level during the axillary view MMG were charted. Results: On MMG, 172 cases were normal, eight cases were benign (Category 2) and three cases indeterminate (Category 3). On USG, 175 cases were normal, three cases were benign (Category 2) and five cases indeterminate (Category 3). Malignant lesions detected in two out of 183 patients (1%) were metastatic carcinoma in bilateral axillary lymph nodes and leiomyosarcoma at the mastectomy site. These two cases were Category 3 on USG with negative MMG findings. In majority of cases (79%), the radiographer had no difficulty performing the axillary view compared with contralateral MMG. Majority of patients (80%) experienced similar pain during axillary view compared to contralateral MMG. Conclusion: Follow-up imaging of post-mastectomy patients should include (i) USG of the mastectomy site, both axillary regions, and the contralateral breast, and (ii) MMG of the contralateral side. Ipsilateral axillary view MMG is not necessary.

Minichromosome maintenance protein 2 is a reliable proliferative marker in breast carcinoma.

This is a study aimed to examine the distribution pattern of a specific minichromosome maintenance protein 2 (MCM2) in benign and malignant breast tissue. We also aim to correlate the frequency of expression of MCM2 with the degree of tumor differentiation. We used immunohistochemistry to examine the distribution and expression pattern of MCM2 on formalin-fixed paraffin-embedded tissue sections of benign (n = 30) and malignant breast tissue (n = 70) (IDC 56, DCIS 4, ILC 2, nonductal 4, mixed type 4). We quantified MCM2 expression by calculating a labeling index, which represents the percentage of epithelial nuclei that stained positively. Immunoreactivity was heterogenous in all the 70 malignant cases examined. Epithelial cells in cycle are most frequent at the tumor periphery. Labeling index of MCM2 was greatest in grade 3 (poorly differentiated) and lowest in grade 1 tumors (well differentiated). Minichromosome maintenance protein 2 expression in breast cancer showed a positive association with histologic grade (P < .05). In all the benign breast tissue examined, no proliferating compartments could be characterized. Minichromosome maintenance protein 2 is a useful proliferative marker of breast carcinoma. The frequency of expression of MCM2 showed an inverse correlation with the degree of tumor differentiation.

Vascular tumours disguising as solid organ injuries on computed tomography: a report of two cases.

We report two cases of uncommon vascular lesions (Littoral cell angioma and liver haemangioma) mimicking traumatic organ injuries. The patients' histories and clinical findings of trauma were well demonstrated. Both patients had interesting CT scan features that were suggestive of solid organ injuries. However, both conditions were subsequently found to be benign incidental lesions.