Parenchymal leiomyoma of the breast: a case report with special reference to magnetic resonance imaging findings and an update review of literature

Abstract

Parenchymal leiomyomas of the breast are extremely rare, with only 25 cases reported in the literature. We report the 26th case of parenchymal leiomyoma of the breast in a 63-year-old woman who presented to us with a right breast tumor detected on her screening mammography. This tumor was evaluated by mammography, ultrasonography, and MR imaging. To the best of our knowledge, this is the first case of a parenchymal leiomyoma of the breast examined by MR imaging. MR imaging revealed an oval mass with circumscribed margins that appeared as a high-intensity lesion in both T1 and T2. A dynamic MRI study showed a gradual increase pattern on the mass. Excisional biopsy revealed a growth pattern of interlacing fascicles of spindle cells without atypia or mitoses, consistent with parenchymal leiomyoma of the breast. Here we report a case of parenchymal leiomyoma of the breast, and describe the clinical, pathological, and immunohistochemical findings. In addition, we review the literature on parenchymal leiomyoma of the breast with regard to clinical characteristics and pathological features of this entity.

Leiomyoma of the breast: an uncommon tumor

“…Smooth muscle is a component that can be present in other lesions, such as fibroadenomas and hamartomas. Leiomyomas located in the parenchyma (as in the case reported here) are circumscribed and 1.0-14.0 cm in diameter (1,2) .…”

“…Leiomyoma of the breast originates from the stroma of the gland and is extremely rare (2) . Mammography and ultrasound studies are commonly used as screening tools.…”

Leiomyoma of the breast parenchyma: a case report and review of the literature

“…In patients with a confirmed diagnosis of breast leiomyoma, no cases of local recurrence have been reported to date. [11][12][13][14][15][16][17][18][19][22][23][24][25][26][27] We reviewed the literature in MEDLINE and Lilacs using the English keywords "leiomyoma", "fibroid tumors", "benign tumor", "benign neoplasms", "breast tumor", "breast neoplasms" and "ultrasonography". We found 30 case reports that described patients with leiomyoma in the breast parenchyma ( Table 2).…”

“…12-14 Mammographic images have been described as showing an isodense or hyperdense oval mass, with outlines that are most often circumscribed (Table 1). 1,13,[15][16][17][18][19][20][21] Microcalcifications relating to leiomyoma have never been described. 15,16,22,23 The effectiveness of mammography is limited in relation to lesions measuring less than 1.0 cm and breasts with predominant glands.…”

“…They pointed out that presence of degeneration can influence the signal pattern in different sequences, as noted in leiomyoma in other regions of the body. 16 The differential diagnosis should be done in relation to lesions that have smooth muscle proliferation in the absence of epithelial or ductal structures. In this context, the lesions that comprise the differential diagnosis are angioleiomyoma, fibroadenoma and malignant phyllodes tumor.…”