Solitary fibrous tumor (SFT) of the breast is a rare mesenchymal tumor composed of spindle-shaped tumor cells with collagen and large blood vessels in the shape of a "staghorn". It is discovered anywhere in the human body, usually incidentally or through nonspecific symptoms. A combination of clinical, histological, and immunohistochemical features is required to establish a diagnosis. There are no proper guidelines for the treatment of SFTs because of their rarity; however, wide surgical excision remains the "gold standard". A multidisciplinary team approach is recommended. They are mostly benign with a 5-year survival rate of 89%. Following a PubMed-indexed English literature review, only six publications presenting nine cases of breast SFT in a male patient were found. The following is the case of a 73-year-old man who presented with dry cough. A SFT in the right breast was discovered incidentally during the investigative work up, and the patient was referred to our Breast Clinic at the Jules Bordet Institute, Brussels, Belgium, for appropriate treatment. The patient's presentation, imaging, and histological sample all supported the diagnosis, and he underwent uneventful surgical resection. Here, we present the first case of an incidental finding of a SFT of the male breast, with its diagnosis and therapeutic challenges.
Primary accessory breast cancer is an extremely rare pathology, representing less than 1% of all breast cancers, and it is found in more than 90% of cases in the axilla. The diagnosis of accessory axillary breast cancer (AABC) is often late and at an advanced stage, with an average delay of 40.5 months. Histological sampling and immunohistochemical results confirm the diagnosis. Most patients are diagnosed with stage II disease or higher, so it is considered to have a poor prognosis. There is no proper management for AABC; it follows the guidelines for orthotopic pectoral breast cancer. We therefore report the case of a 50-year-old woman diagnosed with grade II invasive ductal carcinoma found in accessory axillary breast, treated with neoadjuvant chemotherapy followed by a wide local resection and axillary lymph node dissection.
Myofibroblastoma (MFB), also known as a solitary fibrous tumor of the breast, is a rare sporadic benign tumor composed of spindle-shaped tumor cells with myoblast differentiation. The most typical presentation is a painless unilateral mass that is not connected to any surrounding structure and seldom surpasses 3 cm in size and should be evaluated by using the triple-assessment approach. They have several subtypes, and a definite diagnosis can only be confirmed safely after surgery using immunohistochemistry. Surgical excision serves an essential diagnostic and therapeutic purpose; MFB has a favorable prognosis even when excision margins are positive, and local recurrence is extremely rare. The following is the case of a 73-year-old man who presented with a dry cough. An MFB was discovered by chance during the investigative workup and referred to our department. The patient’s presentation, imaging, and histological samples all supported the diagnosis, and he had surgical resection without incident. We present the second case of an incidental finding of breast MFB and urge clinicians to consider this differential diagnosis.
Primary breast tuberculosis (TB) is a rare extrapulmonary TB mainly affecting young women of childbearing age from endemic countries. Its incidence is increasing in immunocompromised and HIV-infected people and with the emergence of drug-resistant strains of Mycobacterium tuberculosis (MTB). There are no specific clinical signs suggestive of this disease, it often presents as a hard mass or breast abscess. There is an overlap of features with other inflammatory, infectious, benign lesions, fat necrosis and malignant neoplasms of the breast. The detection of MTB remains the gold standard for diagnosis. Several other diagnostic modalities are used, with varying lack of sensitivity and specificity, and with a range of false negatives. A quarter of cases were treated solely on the basis of clinical, imaging or histological suspicion, without confirmation of the diagnosis. Therefore, we report the case of a young Vietnamese woman, presented for a nonhealing breast abscess, and diagnosed with breast TB based on the patient's ethnicity, histological findings, lack of clinical response to conventional antibiotic therapy, and a good clinical response to anti-TB treatment.
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