engleski

Breast leiomyoma - a case report

Introduction Leiomyomas are extremely rare non epithelial breast tumors. They are benign smooth muscle neoplasms common in the genitourinary (uterus) and gastrointestinal tract (small bowel, esophagus)-/2/. First leiomyoma was published by Strong et al in 1913 /5/. Most of them occur in the subareolar region. They are usually solitar and rarely multiple. Herein, we report a case of breast leiomyoma in a 78 years old man with radiologic, histopathologic and immunohistochemical characteristics. Case report A 78-year-old man came to our hospital with history of a palpable oval mass in the left breast. There were no skin changes, nipple discharge, axillary lymphadenopathy, nor history of trauma. Physical examination revealed a well-defined mass in the inner quadrant of the left breast. Ultrasound examination confirmed the presence of 3, 7x6, 0 cm oval, well circumscibed solid mass in the retroaleoral region of the left breast (Figure 1). The lesion was completely excised. Grossly, the well-circumscribed tumor mass measured 6 cm in the largest diameter. The tumor had a firm, homogenous whitish, and whorled cut-surface (Figure 2). Histologicaly, the tumor was composed of spindle smooth-muscle cells without atypia forming interlacing fascicles (Figure 3.) Tumor cells had ovoid nuclei, delicate chromatin and small nucleoli. No pleomorphism, mitoses or necrosis were found. Glandular elements were absent. Tumor cells were immunohistochemicaly positive for SMA and desmin (Figure 3A, 3B.) According to hystopathological and immunohystochemical results, diagnosis was breast leiomyoma. Conclusion Leiomyomas are extremely rare breast tumors reported in men and women. Differential diagnoses include adenoleiomyoma, phyllodes tumor, fibroadenoma with prominent smooth muscle component, fibromatosis, benign spindle cell tumor of the breast, fibrous histiocytoma, myoepithelioma and myoid hamartoma/1/. The origin of breast leiomyoma remains unclear. Various theories have been proposed about the origin of these neoplasm /3/. Kaufman and Hirsh found that they arise from smooth-muscle cells that surround capillares in the subcutaneous tissue of the breast. Diaz-Arias suggested teratoid origin with the extreme overgrowth of myomatous elements, differentiation from multipotent mesenchymal cells and mioepithelial cells/3/. On imaging methods breast leiomyoma mimics fibroadenoma. Histologic examination and IH staining help distinguishing leiomyomas from other tumors. On IH staining the tumor is positive for vimentin, desmin and SMA/3, 4/. Surgical excision is the treatment of choice.

breast leiomyoma

nije evidentirano