Dermatofibrosarcoma Protuberans Mimicking Primary Breast Neoplasm: A case report and literature review

Dermatofibrosarcoma protuberans (DFSP) is a rare, slow-growing mesenchymal neoplasm of the dermis and subcutaneous tissues that has a low- to intermediate-grade malignancy. DFSP commonly involves the trunk and extremities, and very rarely the breast skin, mimicking a primary breast neoplasm with few reported cases in the literature. We report a 35-year old female patient who was referred to the Royal Hospital, Muscat, Oman in 2017, with a two-year history of a slow growing left breast lump. Assessment of the breasts with mammography revealed a lobulated lesion in the left-upper-inner quadrant with neither microcalcification nor architectural distortion, mimicking a benign lesion. However, on ultrasound, the lesion had suspicious features with increased vascularity and hence, it was categorised as breast imaging reporting and data system (BIRAD) IV. The patient underwent left breast wide local excision and the histopathological diagnosis was dermatofibrosarcoma protuberans.Keywords: Breast; Dermatofibrosarcoma Protuberans; Ultrasonography; Oman.

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Dermatofibrosarcoma protuberans. A rare case involving the pediatric foot

Journal of the American Podiatric Medical Association ◽

10.7547/87507315-89-8-419 ◽

1999 ◽

Vol 89 (8) ◽

pp. 419-423 ◽

Cited By ~ 2

Author(s):

JA Cione ◽

B Lynn ◽

J Boylan

Keyword(s):

Rare Case ◽

Malignant Neoplasm ◽

Neck Region ◽

Dermatofibrosarcoma Protuberans ◽

Surgical Excision ◽

Head And Neck Region ◽

Pathologic Features ◽

Pediatric Foot ◽

Grade Malignancy ◽

Slow Growing

Dermatofibrosarcoma protuberans is a rare, slow-growing, locally destructive, intermediate-grade malignancy that originates in the dermal layer of the skin. Dermatofibrosarcoma protuberans rarely metastasizes and has a marked tendency to recur following local surgical excision. The lesion is found most commonly on the trunk, on the proximal aspect of both the lower and upper extremities, and in the head and neck region. Dermatofibrosarcoma protuberans occurs most commonly in people between the ages of 20 and 50. This article describes the clinical and pathologic features of this rare, malignant neoplasm and describes a rare case of dermatofibrosarcoma protuberans involving the pediatric foot.

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Atypical fibroxanthoma

Journal of Clinical Oncology ◽

10.1200/jco.2007.25.18_suppl.20522 ◽

2007 ◽

Vol 25 (18_suppl) ◽

pp. 20522-20522

Author(s):

R. Stadler

Keyword(s):

Benign Lesion ◽

Dermatofibrosarcoma Protuberans ◽

Giant Cells ◽

Observation Time ◽

Low Grade ◽

Rare Tumour ◽

Atypical Fibroxanthoma ◽

The Face ◽

Grade Malignancy ◽

Mitotic Figures

20522 We report on 15 patients who were diagnosed and treated with atypical fibroxanthoma in the Department of Dermatology Minden since 1994. The patients were between 35 and 85 years old with a mean age of 69.9 years. Of the 13 males and 2 females solitary tumours were observed at the ear in 5 patients, at the capillitium in 5 patients, in the face in 3 patients and in the shoulder/axilla area in 2 patients. The lesion were 0.5 to 15 mm in size and half of them ulcerated in severely damaged actinic skin. Histologically, the tumours showed pleomorphic histiocyte proliferation and atypical giant cells often with bizarre nuclei and numerous mitotic figures. Immunohistologically, the tumours were vimentin positive and HMB45, S100, keratin, desmin, EMA, CD34, and actin negative. The clinical evaluation showed no metastatic lesions. The tumours were treated by radical surgery and followed up every half year. The mean observation time is now 24 months without any recurrence. The atypical fibroxanthoma was first reported in 1963 by Helwig. Nowadays, it is thought to be a low grade malignancy as the superficial variant of malignant fibrous histiocytoma. Important is that this tumour follows an indolent behaviour but locally an aggressive course. Small numbers of metastases have been reported. The differential diagnoses includes dermatofibrosarcoma protuberans, malignant melanoma, spindle-cell squamous cell carcinoma and other rare tumour entities The clinical picture should be known not to underestimate this fibrous histiocytic neoplasm as a benign lesion. No significant financial relationships to disclose.

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Dermatofibrosarcoma protuberans of the breast: A case report of a rare breast tumour

World Journal of Advanced Research and Reviews ◽

10.30574/wjarr.2021.11.2.0317 ◽

2021 ◽

Vol 11 (2) ◽

pp. 112-116

Author(s):

CD Emegoakor ◽

HC Nzeako ◽

MI Nwosu ◽

ME Chiemeka ◽

FE Menkiti

Keyword(s):

Dermatofibrosarcoma Protuberans ◽

Breast Tumour ◽

Left Breast ◽

Resection Margins ◽

Case Presentation ◽

Malignant Breast ◽

Similar Appearance ◽

Slow Growing ◽

Firm Mass

Introduction: Dermatofibrosarcoma protuberans (DFSP) is an intermediate and slow-growing sarcoma, arising most commonly in the trunk and extremities and rarely in the breast. It may be recurrent, but metastasis is rare. Excision with good resection margins reduces the rate of recurrence. Case Presentation: A 28-year-old lady presented with a painless lump in the left breast of 16 years duration. Examination revealed an ulcerated firm mass, well defined, with perilesional nodules on the skin of the breast. Wedge biopsy favoured Borderline Phylloides Tumour over DFSP. Patient was offered mastectomy and the histology of the specimen confirmed Fibrosarcomatous DFSP. Conclusion: This stresses the importance of histology in diagnosing a rare breast tumour. This is very important because it may show similar appearance to other benign and malignant breast lesions, which makes clear the role of pathological investigation to make a definitive diagnosis.

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Testicular fibroma: A case report

Archive of oncology ◽

10.2298/aoo1304139s ◽

2013 ◽

Vol 21 (3-4) ◽

pp. 139-140

Author(s):

Sunita Shere ◽

Anjali Kulkarni ◽

Shubhjyoti Pore ◽

Rajan Bindu

Keyword(s):

Case Report ◽

Benign Tumor ◽

Histopathological Diagnosis ◽

Testicular Mass ◽

Rare Benign Tumor ◽

Testicular Malignancy ◽

Slow Growing

Testicular fibroma of gonadal stromal origin is a rare benign tumor of testis, which usually presents as a slow growing testicular mass. Intratesticular fibroma of gonadal stromal origin, with or without minor sex cord elements, must be considered, analogous to similar tumors in ovary, as a benign tumor. Until now, only 25 cases of testicular fibroma have been reported in the literature. We reported a case of testicular fibroma in a 20 years male who presented with painless right testicular enlargement since two years. Ultrasonography (USG) showed heterogeneous mass in right scrotum suggestive of testicular malignancy. Right orchidectomy was done. Histopathological diagnosis was testicular fibroma, which was confirmed by immunohistochemistry.

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Soft tissue masses: distribution of entities and rate of malignancy in small lesions

BMC Cancer ◽

10.1186/s12885-020-07769-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Felix G. Gassert ◽

Florian T. Gassert ◽

Katja Specht ◽

Carolin Knebel ◽

Ulrich Lenze ◽

...

Keyword(s):

Soft Tissue ◽

Benign Lesion ◽

Maximum Diameter ◽

Histopathological Diagnosis ◽

Tumor Diameter ◽

Mr Images ◽

Tissue Mass ◽

Malignancy Rate ◽

Significant Difference ◽

Soft Tissue Masses

Abstract Background Small soft tissue masses are often falsely assumed to be benign and resected with failure to achieve tumor-free margins. Therefore, this study retrospectively investigated the distribution of histopathologic diagnosis to be encountered in small soft tissue tumors (≤ 5 cm) in a large series of a tertiary referral center. Methods Patients with a soft tissue mass (STM) with a maximum diameter of 5 cm presenting at our institution over a period of 10 years, who had undergone preoperative Magnetic resonance imaging and consequent biopsy or/and surgical resection, were included in this study. A final histopathological diagnosis was available in all cases. The maximum tumor diameter was determined on MR images by one radiologist. Moreover, tumor localization (head/neck, trunk, upper extremity, lower extremity, hand, foot) and depth (superficial / deep to fascia) were assessed. Results In total, histopathologic results and MR images of 1753 patients were reviewed. Eight hundred seventy patients (49.63%) showed a STM ≤ 5 cm and were therefore included in this study (46.79 +/− 18.08 years, 464 women). Mean maximum diameter of the assessed STMs was 2.88 cm. Of 870 analyzed lesions ≤ 5 cm, 170 (19.54%) were classified as superficial and 700 (80.46%) as deep. The malignancy rate of all lesions ≤ 5 cm was at 22.41% (superficial: 23.53% / deep: 22.14%). The malignancy rate dropped to 16.49% (20.79% / 15.32%) when assessing lesions ≤ 3 cm (p = 0.007) and to 15.0% (18.18% / 13.79%) when assessing lesions ≤ 2 cm (p = 0.006). Overall, lipoma was the most common benign lesion of superficial STMs (29.41%) and tenosynovial giant cell tumor was the most common benign lesion of deep STMs (23.29%). Undifferentiated pleomorphic sarcoma was the most common malignant diagnosis among both, superficial (5.29%) and deep (3.57%) STMs. Conclusions The rate of malignancy decreased significantly with tumor size in both, superficial and deep STMs. The distribution of entities was different between superficial and deep STMs, yet there was no significant difference found in the malignancy rate.

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Histopathological spectrum of neoplastic and non-neoplastic breast lesions: A three years study in rural tertiary care center.

International Journal Of Medical Science And Clinical Invention ◽

10.18535/ijmsci/v7i01.09 ◽

2020 ◽

Vol 7 (01) ◽

pp. 4721-4725

Author(s):

Dr. Sanjeev Kumar Singh ◽

Dr. Geeta Maurya ◽

Dr. Pinki Pandey ◽

Dr. Rashmi

Keyword(s):

Invasive Ductal Carcinoma ◽

Ductal Carcinoma ◽

Care Center ◽

Benign Lesion ◽

Tertiary Care ◽

Age Distribution ◽

Morbidity And Mortality ◽

Histopathological Diagnosis ◽

Breast Lesions ◽

Neoplastic Lesions

Background: Breast tumours are very common cause of morbidity and mortality worldwide specially in developing countries. Breast lesions show broad spectrum of disease patterns in respect to benign, malignant, and non-neoplastic. Breast cancer is one of the most frequently occurring cancer among women. Objective: To study the frequency, age distribution, clinical and histological patterns of neoplastic and non-neoplastic lesions of breast in this rural population. Material and methods: This observational study was conducted over a duration of three years. In which we studied 210 cases of breast lesions. Specimens were received in department of pathology. Grossing, tissue processing, staining done according to standard protocol. Haematoxylin and eosin (H&E) stained sections were examined under microscope to categorise different type of lesions in the form of non-neoplastic and neoplastic. Results: Out of 210 breast lesions, fibroadenoma was the commonest (114 cases) benign lesion. While invasive ductal carcinoma (70 cases) was commonest in malignant category. Non neoplastic lesions stand on third place, study showed 6 cases out of 210 total cases, in which acute mastitis (4 cases) was most common. Benign tumours were mostly seen in 2nd and 3rd decade and malignant tumour mainly in 5th and 6th decade Conclusion: Early histopathological diagnosis of breast lesions is very important to differentiate between benign and malignant lesions. Large number of cases of invasive ductal carcinoma (>33% of all cases) were seen in our study, which is a serious concern. So, generation of awareness among women is need of time to reduce the morbidity and mortality specially in Indian rural setup

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Adeloye-Odeku Disease in Irrua, South-South Nigeria

Romanian Neurosurgery ◽

10.33962/roneuro-2019-068 ◽

2019 ◽

pp. 431-437

Author(s):

E. Morgan ◽

C. O. Okwumezie ◽

G. C. Akasike ◽

E A. Morgan

Keyword(s):

Dermoid Cyst ◽

Outpatient Clinic ◽

Benign Lesion ◽

Adult Life ◽

Anterior Fontanelle ◽

Group Counselling ◽

Health Institution ◽

The World ◽

Rare Lesion ◽

Slow Growing

First described in a publication by two Nigerian Neurosurgeons, Adeloye A and Odeku EL, in 1971, Adeloye-Odeku disease is a solitary congenital subgaleal inclusion dermoid cyst of the anterior fontanelle. This rare lesion, which makes up about 0.1-0.5% of all cranial tumours and 0.2% of all inclusion cysts, was initially thought to be found only in Africans. However, further reports have shown it to have a universal occurrence, as it has been reported in Caucasians, Chinese, Indians, and other part of the world. This lesion is also known as Congenital inclusion dermoid cyst (CIDS), is a benign slow-growing lesion, and if untreated, may persist to adult life. This article gives a highlight of the disease and its management and goes further to report 3 cases of this rare benign lesion seen in Irrua, South-South Nigeria, a rural, low-resource tertiary health institution. Incidentally and interestingly, all three cases presented within three consecutive months (January-March, 2019) at the neurosurgery outpatient clinic. Being uncomplicated cases, private and group counselling was done. The parents of the patients were much more reassured and relieved from their anxieties seeing others with similar problem. They were all worked up for surgery at different dates, had excision of the cysts with no complication and are currently being followed at the outpatient clinic.

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Mammary analogue secretory carcinoma: a rare salivary gland tumor

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20201703 ◽

2020 ◽

Vol 6 (5) ◽

pp. 998

Author(s):

Shashikant Anil Pol ◽

Surinder K. Singhal ◽

Nitin Gupta ◽

Himanshu Bayad

Keyword(s):

Salivary Gland ◽

Salivary Gland Tumor ◽

Needle Aspiration ◽

Good Prognosis ◽

Low Grade ◽

Secretory Carcinoma ◽

Mammary Analogue Secretory Carcinoma ◽

Grade Malignancy ◽

Enhanced Computed Tomography ◽

Slow Growing

<p>Mammary analogue secretary carcinoma are salivary gland tumors similar to secretary carcinoma of breast histologically. It usually affects adults with mean age group of 45 years. Clinically it is usually slow growing, low grade malignancy with favorable prognosis. We are reporting a case of 47 years old female presented with complaints of swelling behind left ear for last 7 years. It was slow growing, painless and persistent. On examination, 4 x 3 cm swelling was present just below left ear lobule. It was nontender, firm, irregular in shape with smooth surface with slight mobility and overlying skin pinchable. Fine needle aspiration cytology suggested benign tumor with cystic change. On contrast enhanced computed tomography scan, there was a lobulated hypodense lesion measuring 24×35×32 mm with internal septations and enhancement of wall in expected location of superficial as well as deep lobe of left parotid gland. Patient underwent left total conservative parotidectomy and histopathology came out to be secretory analogue mammary carcinoma. Subsequently she received post-operative radiotherapy. Patient is on regular follow up and disease free till date. Usually mammary analogue secretory carcinoma is a low-grade malignancy with good prognosis. Immunohistochemistry is confirmatory which shows positivity for S-100 protein and mammaglobin.</p>

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Automatic detection of various patterns of calcification distribution on mammograms: a graph convolution network approach (Preprint)

10.2196/preprints.32188 ◽

2021 ◽

Author(s):

Melissa Min-Szu Yao ◽

Hao Du ◽

Mikael Hartman ◽

Wing P. Chan ◽

Mengling Feng

Keyword(s):

Breast Cancer ◽

Breast Imaging ◽

Characteristic Curve ◽

Area Under The Curve ◽

Automatic Detection ◽

Ground Truth ◽

Architectural Distortion ◽

Breast Cancers ◽

Convolutional Network ◽

Mammographic Images

UNSTRUCTURED Purpose: To develop a novel artificial intelligence (AI) model algorithm focusing on automatic detection and classification of various patterns of calcification distribution in mammographic images using a unique graph convolution approach. Materials and methods: Images from 200 patients classified as Category 4 or 5 according to the American College of Radiology Breast Imaging Reporting and Database System, which showed calcifications according to the mammographic reports and diagnosed breast cancers. The calcification distributions were classified as either diffuse, segmental, regional, grouped, or linear. Excluded were mammograms with (1) breast cancer as a single or combined characterization such as a mass, asymmetry, or architectural distortion with or without calcifications; (2) hidden calcifications that were difficult to mark; or (3) incomplete medical records. Results: A graph convolutional network-based model was developed. 401 mammographic images from 200 cases of breast cancer were divided based on calcification distribution pattern: diffuse (n = 24), regional (n = 111), group (n = 201), linear (n = 8) or segmental (n = 57). The classification performances were measured using metrics including precision, recall, F1 score, accuracy and multi-class area under receiver operating characteristic curve. The proposed achieved precision of 0.483 ± 0.015, sensitivity of 0.606 (0.030), specificity of 0.862 ± 0.018, F1 score of 0.527 ± 0.035, accuracy of 60.642% ± 3.040% and area under the curve of 0.754 ± 0.019, finding method to be superior compared to all baseline models. The predicted linear and diffuse classifications were highly similar to the ground truth, and the predicted grouped and regional classifications were also superior compared to baseline models. Conclusion: The proposed deep neural network framework is an AI solution to automatically detect and classify calcification distribution patterns on mammographic images highly suspected of showing breast cancers. Further study of the AI model in an actual clinical setting and additional data collection will improve its performance.

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Histo-pathological correlation of BI-RADS 4 lesions on mammography with emphasis on microcalcification patterns.

South African Journal of Radiology ◽

10.4102/sajr.v12i4.549 ◽

2008 ◽

Vol 12 (4) ◽

pp. 84

Author(s):

F Ismail ◽

J Holl ◽

Z Lockhat ◽

H J Akande

Keyword(s):

Retrospective Study ◽

Physical Examination ◽

Digital Mammography ◽

Classification System ◽

Breast Imaging ◽

Data System ◽

Architectural Distortion ◽

Final Histology ◽

Radiological Appearance ◽

Study Population

A retrospective study of 20 patients with Breast Imaging Reporting and Data System (BI-RADS) 4 lesions was undertaken. These patients were classified as BI-RADS 4 lesions due to presence of a mass (clinical or on mammography), architectural distortion and microcalcifications (MC). In some patients, the pattern of MC was benign but there were other features that were suspicious of malignancy. A comparison was made with the histological diagnosis in order to compare the radiological appearance of benign and malignant microcalcification patterns with the final histology. The study design included retrospective analysis of patients with MC on digital mammography who underwent biopsy. An analysis of the histology was then undertaken. Other factors in the history and physical examination were also considered. Results showed that although the study was not statistically significant due to limited study population, interesting trends are determined in assessing calcification patterns using the Breast Imaging Reporting and Data System (BI-RADS) classification system, since some lesions that were thought to have benign calcification patterns were actually malignant and vice versa. Further study in this field is required.

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