Benign cyst of the male breast. An exceedingly rare entity that may pose a diagnostic dilemma. Management and literature review

2021 ◽  
pp. 1-5
Author(s):  
Nikolaos S. Salemis
Keyword(s):  
Breast Imaging ◽  
Breast Lesions ◽  
Imaging Features ◽  
Rare Entity ◽  
Rare Occurrence ◽  
Review Of The Literature ◽  
Diagnostic Dilemma ◽  
Breast Cyst ◽  
Underlying Malignancy ◽  
Male Patients

Cysts represent the most common cause of a breast mass in women. On the contrary, in men, the presence of a benign apocrine cyst is an exceedingly rare occurrence, with only a few cases reported in the literature. We describe herein a case of benign apocrine breast cyst without concurrent gynecomastia in a 41-year-old male. Diagnostic evaluation and management are discussed, along with a review of the literature. Given the extreme rarity of benign breast cysts in males, a thorough investigation is essential in male patients presenting with cystic breast lesions. Diagnostic breast imaging may be challenging. Surgical resection of the cyst should be considered in the presence of atypical imaging features to exclude underlying malignancy.

Concurrent thyrolipomatosis and thymolipoma in a patient with myasthenia gravis: a case report and review of the literature

2021 ◽  
Vol 103 (7) ◽  
pp. e212-e215
Author(s):  
T Campion ◽  
A Maity ◽  
S Ali ◽  
P Richards ◽  
A Adams
Keyword(s):  
Case Report ◽  
Myasthenia Gravis ◽  
Clinical Importance ◽  
Imaging Features ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Neck Lump

We present a case of a man with a background of myasthenia gravis who presented with a neck lump, which was diagnosed as thyrolipomatosis in continuity with a very large thymolipoma. Following removal of these lesions, the patient’s myaesthenic symptoms improved. While thymolipomas are often seen in the context of myasthenia gravis, thyrolipomatosis is a rare entity and to our knowledge the concurrent finding of both lesions with myasthenia gravis has never been reported. We highlight the important imaging features of both entities and the clinical importance of recognising them.

scholarly journals PAX5-Negative Classical Hodgkin Lymphoma: A Case Report of a Rare Entity and Review of the Literature

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Elham Vali Betts ◽  
Denis M. Dwyre ◽  
Huan-You Wang ◽  
Hooman H. Rashidi
Keyword(s):  
Case Report ◽  
Hodgkin Lymphoma ◽  
Germinal Center ◽  
English Literature ◽  
Rare Entity ◽  
Classical Hodgkin Lymphoma ◽  
Review Of The Literature ◽  
Diagnostic Dilemma ◽  
Small Minority ◽  
Cell Neoplasm

Classical Hodgkin lymphoma (CHL) is recognized as a B-cell neoplasm arising from germinal center or postgerminal center B-cells. The hallmark of CHL is the presence of CD30 (+) Hodgkin and Reed-Sternberg (HRS) cells with dim expression of PAX5. Nearly all of the HRS cells are positive for PAX5. However, a small minority of HRS cells may lack PAX5 expression, which can cause a diagnostic dilemma. Herein we describe two cases of PAX5-negative CHL and review of the English literature on this very rare entity. It is crucial to be aware of this phenomenon, which in some cases may lead to misdiagnosis and may ultimately adversely affect patient’s management.

scholarly journals Primary Amelanotic Rhabdoid Melanoma: A Case Report with Review of the Literature

2015 ◽  
Vol 7 (3) ◽  
pp. 292-297 ◽  
Author(s):  
Takahide Kaneko ◽  
Ayumi Korekawa ◽  
Eijiro Akasaka ◽  
Daiki Rokunohe ◽  
Hajime Nakano ◽  
...  
Keyword(s):  
Tumor Cells ◽  
Subsequent Treatment ◽  
Rare Entity ◽  
Rare Occurrence ◽  
Review Of The Literature ◽  
Cytoplasmic Inclusions ◽  
Pulmonary Alveoli ◽  
Old Japanese ◽  
S 100 ◽  
Hmb 45

Primary rhabdoid melanoma (PRM) is a rare variant of melanoma. Herein, we describe a case of primary amelanotic rhabdoid melanoma and review the clinicopathological features of previously reported cases of PRMs. A 63-year-old Japanese man presented with a nonpigmented red granular tumor without peripheral pigmented macules on the left heel measuring 21 × 18 mm in size. Light microscopic examination revealed a tumor mass composed entirely of polygonal neoplastic cells resembling pulmonary alveoli. Tumor cells were also discohesive with bizarre nuclei, prominent nucleoli and large hyaline cytoplasmic inclusions. No melanin pigment was present. Tumor cells were strongly and diffusely positive for S-100, MART-1, HMB-45 and vimentin, while negative for desmin, αSMA and synaptophysin. According to previous reviews, PRM tends to be amelanotic and nodular. S-100 protein and vimentin stained in all cases contrary to low stainability for HMB-45, which was, by contrast, positive in our case. Prognosis of PRM remains controversial due to the very rare occurrence of this tumor and the small number of confirmed cases that have been reported. Recognition of this rare entity is important in clinical practice even for skillful dermatologists to avoid misdiagnosis with the other tumors and to determinate the subsequent treatment principles.

scholarly journals Characteristics and Management of Male Breast Parenchymal Cysts

2020 ◽  
Vol 2 (4) ◽  
pp. 330-335
Author(s):  
Santo Maimone ◽  
Idris T Ocal ◽  
Kristin A Robinson ◽  
Martha C Wasserman ◽  
Robert W Maxwell
Keyword(s):  
Breast Imaging ◽  
Patient Characteristics ◽  
Male Breast ◽  
Institutional Review Board ◽  
Rare Entity ◽  
Case Review ◽  
Breast Cyst ◽  
Radiology Reports ◽  
Institutional Review

Abstract Objective Parenchymal breast cysts are considered to be rare in men and are sparsely described in the literature. The purpose of this study was to review our institution’s experience with male breast cysts in an effort to improve overall understanding and management of this rare entity. Methods An institutional review board–exempt retrospective study was performed. Radiology reports for males who underwent mammogram and/or breast ultrasound at any of our institution’s primary or satellite locations from January 1995 to January 2020 were screened to find males with breast cysts. If cysts were reported and images were available, case review was performed to confirm parenchymal breast cyst(s) and patient characteristics were collated. Results Of 5425 male cases presenting for breast imaging, 19 (0.4%) cases of male breast cysts were confirmed, with a mean patient age of 41.6 years (range: 2–81 years). The most common indication leading to cyst discovery was a palpable lump, corresponding to the site of the cyst in 5 (26.3%) patients and near the site where cyst(s) were ultimately discovered in 7 (36.8%) patients. There were 8 (42.1%) instances of cysts without concurrent gynecomastia. Three (15.8%) men underwent needle sampling. There were no cases of atypia or malignancy on needle biopsy or on subsequent clinical follow-up, with median clinical follow-up of 70.3 months (range: 3.3–259.4 months). Conclusion Male breast parenchymal cysts are rare, but their prevalence is likely underestimated. If detected incidentally or upon targeted evaluation, biopsy may be averted if classic benign cyst features are identified.

Value of contrast-enhanced malignancy imaging features in secondary grade diagnosis of BI-RADS-US type 4 breast lesions

2020 ◽  
pp. 030089162096571
Author(s):  
Junxi Gao ◽  
Wei Han ◽  
Di Li Mu La Ti Ai Si Mu Tu La ◽  
Xueqin Hou ◽  
Zhi Ming Li ◽  
...  
Keyword(s):  
Breast Imaging ◽  
Benign Lesion ◽  
Breast Lesions ◽  
Imaging Features ◽  
Contrast Enhanced Ultrasound ◽  
Contrast Enhanced ◽  
Peripheral Ring ◽  
Malignant Lesions ◽  
Type 3

Purpose: To explore the value of contrast-enhanced malignancy imaging features in secondary grade diagnosis of Breast Imaging Reporting and Data System for Ultrasonography (BI-RADS-US) type 4 breast lesions. Methods: After initial diagnosis by ultrasound, 124 BI-RADS-US type 4 patients with 130 lesions were examined by contrast-enhanced ultrasound (CEUS) and were classified again before surgery according to five contrast-enhanced malignancy imaging features: inhomogeneous enhancement, peripheral ring-like enhancement, expansive enhancement, internal filling defects, and surrounding radioactive convergence. Lesions with no contrast-enhanced features of malignancy were categorized as type 3; lesions with one, two, or three features of malignancy were categorized as type 4A, 4B, or 4C, respectively; and lesions with four or more indices of malignancy were categorized as type 5. The value of contrasted imaging features of malignancy in diagnosing BI-RADS-US type 4 breast lesions was analyzed. Results: The accuracy of CEUS diagnosis for type 3 lesions was 93.8% (46/49), 76.9% (10/13) for type 4A, 71.4% (5/7) for type 4B, 75.0% (9/12) for type 4C, and 93.8% (46/49) for type 5 lesions. The sensitivity of CEUS in diagnosing malignant lesions was 90.4%, specificity was 83.6%, and accuracy was 86.9%. CEUS decreased the benign lesion biopsy ratio to 68.5% (46/67) and increased the diagnosis ratio of malignant lesions to 73.0% (46/63). Conclusions: CEUS can further optimize the classification of BI-RADS-US type 4 breast lesions and may provide a better reference basis for clinical diagnosis and treatment of those breast lesions.

scholarly journals Clinical diagnostic dilemma: Oral verruciform xanthoma

2022 ◽  
Vol 7 (4) ◽  
pp. 243-246
Author(s):  
Manavadaria Yash C ◽  
Kale Tejraj P ◽  
Naik Veena V ◽  
Motimath Abhishek S
Keyword(s):  
Oral Mucosa ◽  
Surgical Excision ◽  
Rare Entity ◽  
Review Of The Literature ◽  
Literature Study ◽  
Diagnostic Dilemma ◽  
Verruciform Xanthoma ◽  
One Year ◽  
Papillary Growth ◽  
Local Surgical Excision

Verruciform xanthoma is a specific but not so common, papillary growth typically occurring on the oral mucosa of middle-aged persons. It is a unique entity and has found to be incident in 0.025-0.05% of all cases reported as per the literature study. One such case of 75 days duration was successfully managed with complete local surgical excision. The surgical site was monitored for one year postoperatively with no signs of recurrence or other postoperative complications. Clinical perspective, histopathological highlights and differential interpretation is discussed in this article with an in-depth review of the literature. It is important to consider this rare entity in the differential diagnosis of lesions involving oral mucosa as its clinical and histological features overlap with several other lesions.

Varicose vein surgery under anti-platelet therapy

Phlebologie ◽  
2008 ◽  
Vol 37 (06) ◽  
pp. 287-297 ◽  
Author(s):  
P.-M. Baier ◽  
Z. T. Miszczak
Keyword(s):  
Varicose Vein ◽  
Bleeding Time ◽  
Varicose Veins ◽  
Bleeding Risk ◽  
Bleeding Complications ◽  
Review Of The Literature ◽  
Varicose Vein Surgery ◽  
Anti Platelet Therapy ◽  
Male Patients ◽  
Acute Atherothrombosis

Summary Background: Platelet function inhibitors (PFI) are used for prophylaxis of atherothrombosis. These drugs cause a prolongation of the bleeding time and should eventually be stopped before an elective operation. However, there is a risk that a perioperative pause of PFI lead to acute atherothrombosis. Objective: Our aim was to study whether a discontinuation of PFI therapy is necessary to avoid bleeding complications in patients undergoing varicose vein surgery. Methods: Selective review of the literature and retrospective analysis of clinical data of our own patients. Results: In the years 2002 to 2007 a total of 10 827 patients have been operated on varicose veins, 673 (6.2%) of these aged 32–86 years (67 ± 7.9) receiving permanent PFI therapy: 256 male patients (38.0%) and 417 female (62.0%), 39.1% categorized as ASA III patients: male 11.6%, female 27.5%. 38 patients who continued PFI therapy did not demonstrate haemorrhagic complications and none of those pausing anti-platelet medication experienced thromboembolic complications. The literature survey confirmed our finding that it is not necessary to suspend PFI medication for varicose vein surgery as the bleeding risk can be controlled for by technical means. Conclusion: Discontinuation of PFI therapy prior to interventions on varicose veins does not seem to be necessary, further studies are essential though.

scholarly journals Evaluation of image quality at the detector’s edge of dedicated breast positron emission tomography

2021 ◽  
Vol 8 (1) ◽  
Author(s):  
Yoko Satoh ◽  
Utaroh Motosugi ◽  
Masamichi Imai ◽  
Yoshie Omiya ◽  
Hiroshi Onishi
Keyword(s):  
Image Quality ◽  
Chest Wall ◽  
Clinical Studies ◽  
Breast Imaging ◽  
Phantom Study ◽  
Breast Lesions ◽  
Clinical Images ◽  
Dedicated Breast Pet ◽  
Pet Ct ◽  
Significant Difference

Abstract Background Using phantoms and clinical studies in prone hanging breast imaging, we assessed the image quality of a commercially available dedicated breast PET (dbPET) at the detector’s edge, where mammary glands near the chest wall are located. These are compared to supine PET/CT breast images of the same clinical subjects. Methods A breast phantom with four spheres (16-, 10-, 7.5-, and 5-mm diameter) was filled with 18F-fluorodeoxyglucose solution (sphere-to-background activity concentration ratio, 8:1). The spheres occupied five different positions from the top edge to the centre of the detector and were scanned for 5 min in each position. Reconstructed images were visually evaluated, and the contrast-to-noise ratio (CNR), contrast recovery coefficient (CRC) for all spheres, and coefficient of variation of the background (CVB) were calculated. Subsequently, clinical images obtained with standard supine PET/CT and prone dbPET were retrospectively analysed. Tumour-to-background ratios (TBRs) between breast cancer near the chest wall (close to the detector’s edge; peripheral group) and at other locations (non-peripheral group) were compared. The TBR of each lesion was compared between dbPET and PET/CT. Results Closer to the detector’s edge, the CNR and CRC of all spheres decreased while the CVB increased in the phantom study. The disadvantages of this placement were visually confirmed. Regarding clinical images, TBR of dbPET was significantly higher than that of PET/CT in both the peripheral (12.38 ± 6.41 vs 6.73 ± 3.5, p = 0.0006) and non-peripheral (12.44 ± 5.94 vs 7.71 ± 7.1, p = 0.0183) groups. There was no significant difference in TBR of dbPET between the peripheral and non-peripheral groups. Conclusion The phantom study revealed poorer image quality at < 2-cm distance from the detector’s edge than at other more central parts. In clinical studies, however, the visibility of breast lesions with dbPET was the same regardless of the lesion position, and it was higher than that in PET/CT. dbPET has a great potential for detecting breast lesions near the chest wall if they are at least 2 cm from the edge of the FOV, even in young women with small breasts.

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