Adenolipoma of the breast

Giornale di Chirurgia - Journal of Surgery, 2013

2016

Breast hamartomas “Breast within a breast” is a rare entity with a low incidence (0.1 – 7%). It was first mentioned by Hogeman and Ostberg in 1968, and described by Arrigoni et al [6] in 1971. They clinically resemble fibroadenoma. The concern with the condition is that it may present as a palpable breast lump or may be identified on sometimes routine mammographic examination leading to appropriate triple test and its associated investigations to rule out possible breast malignancy. They have a possibility for malignant transformation and thus should be speculated and treated in the same manner. We present the case of a 36 year old female with a palpable breast lump identified as fibroadenomatoushamartoma. Simple excision is was treatment of choice as there was no coincidental epithelial malignant lesion. No recurrence or complications developed in the post-operative and follow-up period.

Radiology Case Reports, 2020

International Journal of Research in Medical Sciences, 2018

Breast hamartoma is an underdiagnosed and poorly recognized rare benign lesion, accounting for approximately 4.8% of all benign breast lumps. There is lack of awareness of the characteristic clinical and histologic features of this entity in clinicians and pathologists. The pathogenesis of the development of breast hamartoma is still not fully understood. A 23-year-old female presented with a huge painless lump in right breast. The lump was present since last nine years. It was previously of the size of a bean, which rapidly increased to the present size during her pregnancy. FNAC revealed features of lipoma. However, on histopathological examination diagnosis of Hamartoma was rendered. A definitive diagnosis of hamartoma is hard to achieve on clinical examination, imaging studies and fine needle aspiration cytology. A correlation of histology, imaging findings with clinical impression is necessary.

International Surgery Journal, 2016

Clinics, 2014

OBJECTIVES: Breast hamartoma is an uncommon breast tumor that accounts for approximately 4.8% of all benign breast masses. The pathogenesis is still poorly understood and breast hamartoma is not a well-known disorder, so its diagnosis is underestimated by clinicians and pathologists. This study was designed to present our experience with breast hamartoma, along with a literature review. METHOD: We reviewed the demographic data, pathologic analyses and imaging and results of patients diagnosed with breast hamartoma between December 2003 and September 2013. RESULTS: In total, 27 cases of breast hamartoma operated in the Ankara University Medicine Faculty's Department of General Surgery were included in the study. All patients were female and the mean age was 41.8¡10.8 years. The mean tumor size was 3.9¡2.7 cm. Breast ultrasound was performed on all patients before surgery. The most common additional lesion was epithelial hyperplasia (22.2%). Furthermore, lobular carcinoma in situ was identified in one case and invasive ductal carcinoma was observed in another case. Immunohistochemical staining revealed myoid hamartoma in one case (3.7%). CONCLUSION: Breast hamartomas are rare benign lesions that may be underdiagnosed because of the categorization of hamartomas as fibroadenomas by pathologists. Pathologic examinations can show variability from one case to another. Thus, the true incidence may be higher than the literature indicates.

Breast hamartoma is a rare, well-circumscribed, benign lesion made up of a variable quantity of glandular, adipose and fibrous tissue. This is a lesion that can affect women at any age from puberty. With the increasingly frequent use of imaging methods such as mammography and ultrasound as well as breast biopsy, cases of hamartoma diagnosed are increasing. The diagnosis of these lesions is made by mammography. The histological and radiological aspects are variable and depend on its adipose tissue content. The identification of these lesions is important in order to avoid surgical excisions. We report radio-clinical and pathological records of breast hamartoma.

Histopathology, 1994

Hamartomas of the breast: six novel diagnostic features in three-dimensional thick sections Fifteen hamartomas of the breast have been studied by dissecting microscopy of thick sections at a depth of 1 .O to 2.5 mm, and by conventional 5 pm deep sections. This combined approach has revealed six distinctive features, three in the parenchymal structure and three in the connective tissue components. Ducts (invariably of penetrating or arcuate configuration) and discrete lobules, neither of which are seen in lesions accepted as fibroadenomas, were invariably found. In one-third of hamartomas, up to 10% of the surface area was occupied by Herati-style nodules composed of concentric rings of epithelium. In the hyaline interlobular connective tissue characteristic drifts of caraway seed-like fibrocytes, encasement of adipocytes by hyaline collagen. or spider-naevus vascular abnormalities were found in approximately half of the mammary hamartomas when examined in thick sections. Hitherto the positive diagnosis of hamartomas of the breast has relied on a combined clinical, radiological and pathological assessment. We suggest that the additional features described here, taken in conjunction with those already known, may facilitate the recognition of mammary hamartomas by histopathological examination alone.

Breast Care, 2008

Hintergrund: Myoepitheliale Zellen sind überall in der Brust zu finden. Eine Hyperplasie dieser Zellen kann zu einem weiten Erkrankungsspektrum von Myoepitheliose bis hin zu myoepithelialen Karzinomen führen. Fallbericht: Eine 46-jährige Frau wurde mit einer tastbaren Geschwulst in der rechten Brust vorstellig. Die mammographische und Ultraschalluntersuchung zeigten eine Läsion mit spikulierter Begrenzung und Form im oberen Quadranten der rechten Brust. Die Untersuchung der Exzisionsbiopsie ergab eine adenomyoepitheliale Adenose. Schlussfolgerungen: Adenomyoepitheliale Läsionen gelten zwar als gutartig, auf Grund unvollständiger Entfernung rezidivieren sie aber häufig. Deshalb sollte das mögliche Auftreten von Rezidiven und sogar Metastasen während des Follow-ups von Patienten mit adenomyoepithelialen Läsionen im Auge behalten werden.

European Journal of Breast Health, 2021

Objective: Breast hamartomas are rare, benign, and slow-growing breast tumors that can be definitively diagnosed by combining the results of clinical, radiological, and histopathological examination. This study aimed to evaluate the clinical, radiological, and histopathological features of hamartomas and summarize our clinical approach to hamartomas. Materials and Methods: Patients diagnosed with breast hamartoma between 2010 and 2020 in our clinic were retrospectively analyzed. Demographic information, clinical examination, radiological findings, histopathological features, changes during follow-up, and follow-up data were obtained and analyzed. Results: Of the 1,429 patients operated on in our clinic for benign breast diseases between January 2010 and March 2020, 39 (2.7%) were diagnosed with breast hamartomas with histopathological examination. All patients were women with a median age of 37 (19-62) years. Most of the patients (64%) were in the premenopausal period. Radiological examinations were conducted using mammography (66%), breast ultrasonography (100%), and breast magnetic resonance imaging (48%). Biopsy was performed in 14 preoperative patients, and nine (64%) patients were diagnosed with hamartoma. All patients were operated on; 37 patients underwent a lumpectomy, and two had a mastectomy. No patients had hamartoma recurrence during an average follow-up period of 39 months. Conclusion: Hamartomas are similar to other benign breast pathologies. Definitive diagnosis can be achieved by combining the results of clinical, radiological, and histopathological examination. Given its similar composition to normal breast tissue, hamartoma has a low rate of malignancy. Definitive diagnosis and appropriate surgical treatment are required.

2020

Introduction: An adenolipoma is a benign, rare variant of a lipoma and is histologically very similar to a lipoma but contains eccrine glands amongst the mature adipose tissue. According to our knowledge, this case series of adenolipomas, is the largest one in the literature. The aim is to increase awareness about this variant of lipoma.Method: The data was collected retrospectively from the histopathology department and patients’ notes.Results: We had a total of 16 cases of adenolipomas between 2013 and 2017 in our hospital. 75% of the patients were being managed by General Surgeons. 88% of them occurred in female patients and the patients’ age varied between 15 and 64 years. The most common location of adenolipomas was the thighs and the largest diameter of the histology specimen varied between 15 and 100mm. 31% were encapsulated, 25% had apocrine glands present and 6% had myxoid changes. None of them had mast cells present. No recurrences were documented.Conclusion: It is a benig...

Radiology Case Reports, 2021

Myoid (muscular) hamartoma is a rare form of benign breast hamartoma composed of differentiated mammary glandular and stromal structures, fatty tissue and areas of smooth muscle from which its name originates. It is considered to be a variant of a mammary hamartoma. We report the clinical presentation, imaging appearances and treatment of the initial and recurrent presentation of this rare tumour in a 61year old female, which mimicked malignancy. Although rare, myoid hamartoma's can reoccur and when they do they imaging appearances of benign and malignant tumours can overlap tend to mimic malignancy and histological diagnosis is mandatory.

Annals of Pathology and Laboratory Medicine, 2021

Hamartoma is a local malformation resulting from faulty development in an organ. It was first described in breast in 1971 by Arrigoni et al and its occurrence in breast is very rare. This tumor is composed of breast lobules admixed with fibrous tissue and fibroadipose tissue. Myoid hamartoma, also called as muscular hamartoma , is composed of smooth muscle cells in addition to ducts, lobules, and stroma. Here, we report a case of myoid hamartoma which occurred in a 53year old lady with a lump in the right breast.

Schlüsselwörter Brust · Hamartom · Myoid · Muskulär Zusammenfassung Hintergrund: Das myoide (muskuläre) Hamartom (MH) der Brust ist eine seltene, gutartige, tumorigene Läsion bestehend aus differenzierten Strukturen des Drüsen­ gewebes und des Stromas, Fettgewebe und glatter Mus­ kulatur. Das MH wird als eine Nebenform des Hamar­ toms der Brust verstanden. Fallbericht: Wir berichten von einer 46­jährigen Frau mit MH und geben einen Überblick über die Literatur zur Herkunft der glatten Muskelzellen. Histologisch bestand der Tumor aus fibro­ lipomatösem Stroma sowie duktalen und lobulären Strukturen der Brust hauptsächlich im Grenzbereich des Tumors. Die Drüsenanteile zeigten Anzeichen von mikro­ und makrozystischen Veränderungen, apokriner Meta­ plasie und Adenose. Das Hauptmerkmal war eine faszi­ kuläre Formation von Spindelzellen, hauptsächlich im Zentrum des Tumors, mit Invasion interglandulärer Strukturen. Immunhistochemisch waren die Herde glat­ ter Muskulatur positiv für Desmin, Smooth­Muscle­Aktin und h­Caldesmon. Expression der Östrogen­ und Pro­ gesteronrezeptoren (PR) war positiv und deutlich höher für PR. Expression von CD34, S­100­Protein und CD10 war negativ. Schlussfolgerungen: Die Herkunft der glat­ ten Muskelzellen beim MH ist unbekannt. Aufgrund des Hormonrezeptorexpressionsmusters wird jedoch ange­ nommen, dass sie durch Metaplasie aus hormonsensib­ len Stromazellen der Brust entstehen. Summary Background: Myoid (muscular) hamartoma (MH) of the breast is a rare benign tumour­forming lesion composed of differentiated mammary glandular and stromal struc­ tures, fatty tissue, and areas of smooth muscle. It is con­ sidered to be a variant of mammary hamartoma. Case Report: We report the case of a 46­year­old woman with MH, and provide a literature review explaining the origin of smooth muscle cells. Histologically, the tumour con­ sisted of fibrolipomatous stroma containing ductal and lobular structures of the mammary gland located mainly at the tumour borders. The glandular structures showed signs of micro­ and macrocystic changes, apocrine meta­ plasia, and adenosis. The dominant feature was the presence of a fascicular formation of spindle cells, pre­ dominantly in central parts, with incursion between glandular structures. Immunohistochemically, foci of smooth muscle tissue were positive for desmin, smooth muscle actin, and h­caldesmon. Oestrogen and proges­ terone receptors (PR) showed positive expression which was markedly higher for PR. There was negative expres­ sion of CD34, S­100 protein, and CD10. Conclusions: The origin of smooth muscle cells in MH is unknown. However, it is presumed to be derived from hormonally responsive breast stromal cells by smooth muscle meta­ plasia, based on evidence of hormone receptor expres­ sion in the lesion.

Breast Disease, 2017