Fibromatosis of the Male Breast: A Case Report With Immunohistochemistry Study and Review of the Literature.

Abstract

Fibromatosis is an infiltrative proliferation of fibroblastic and myofibroblastic cells with significant risk for local recurrence, but no metastatic potential.1 It originates mainly from the fascia or aponeuroses of the abdominal wall muscles or from the muscles of the shoulders and pelvic girdles.1 Fibromatosis is uncommon in the mammary gland and accounts for less than 0.2% of all primary breast lesions.2,3 Although several series of this condition have been reported in women, mammary fibromatosis in men is extremely rare. [4][5][6][7] Despite its rarity, this condition may mimic primary breast malignancy. In cases where suspicious breast findings do not correlate with the usual diagnostic measures, such as those from fine-needle aspiration or core needle biopsy, the diagnosis of a fibromatosis mimicking breast cancer should be considered in the differential diagnosis. [8][9] We report the case of a 47-year-old man with mammary fibromatosis. To the best of our knowledge, this is the sixth case of fibromatosis reported in the male breast. [4][5][6][7] The optimal management of breast fibromatosis in men is unknown because of the rarity of the disease. A review of articles published on breast fibromatosis was performed using the PUBMED-MEDLINE database with emphasis on articles published during the last 10 years. CASE REPORTWe present the case of a 47-year-old man who was admitted to the Outpatient Breast Oncology Service, Department of Health of São Carlos, Brazil, with a 3-month history of a painless subcutaneous mass with rapid growth. Clinical examination revealed an ill-defined mass located in the upper inner quadrant of his left breast tissue measuring of 3.5 cm in diameter. The mass was firm and was fixed to the pectoral fascia and to skin. There was no axillary or cervical lymphadenopathy or nipple discharge.At ultrasound, the lesion manifested as an irregular, hypoechoic mass with posterior acoustic shadowing, suggestive of malignancy. Fine-needle aspiration cytology was performed, but the result was inconclusive because the aspirate did not yield sufficient epithelial cells for diagnosis. The tumor was removed by en bloc resection with wide excision, the greater pectoral muscle being spared. During surgery the lesion was found to be firmly adherent to the underlying pectoralis major. The appearance was that of an infiltrative tumor, and the diagnosis of epithelial neoplasm was considered in the differential diagnosis. There was no history of trauma to the chest wall, so that a fibrous reaction to trauma was not considered in the differential diagnosis.The surgical specimen was fixed in 4% formalin. Sequential 3-mm sections were obtained throughout the specimen. Representative samples of the tumor were embedded in paraffin, and histological sections of 4 µm obtained from the paraffin-embedded blocks were stained with hematoxylin-eosin. The histological sections stained with hematoxylin-eosin showed a proliferation of spindle cells without atypia forming sweeping or interlacing fascicles (Figure 1). The...

Breast fibromatosis associated with breast implants

“…The risk factors for recurrence include a large tumor size, a young age, and a positive operative margin [17]. However, breast fibromatosis has a lower recurrence rate (21-27 %) than extramammary fibromatosis (30-65 %) [25]. Other possible treatment options including chemotherapy, radiotherapy, and hormonal therapy have been suggested to improve local control rates [14].…”

Bilateral Breast Fibromatosis: Case Report and Review of the Literature

“…3 The mammary gland is one of the rarest sites in which fibromatosis has been described, representing a 4% of extra-abdominal DTs and only 0.2% of primary breast lesions. [4][5][6] The mean age for diagnosis of breast fibromatosis is 35 to 50.3 years. Only approximately 6 case series and 100 case reports of breast fibromatosis are available, 7 and only 5 of them report both breasts involvement.…”

Fibromatosis of the breast in a 52-year-old man (2010: 10b)

“…It typically occurs in the abdominal wall, and it is very uncommon in the breast, where it represents less than 0.2% of primary lesions [1]. Although fibromatosis of the breast occurs predominantly in women, it can rarely affect the male breast.…”