Rare benign tumor in a prepubescent accessory breast: a case report

Background Polymastia or accessory breast is a congenital condition seen in 1% of the population at birth and in 2–6% of the female population. The most common presentation is in the pubertal age group when secondary sexual characters begin to develop or during pregnancy and lactation. Giant cell fibroblastoma is an exceedingly rare benign soft tissue neoplasm in the pediatric age group, usually seen over the back and thigh. We report a case of giant cell fibroblastoma in accessory breast tissue in a 4-year-old, female child. This case is rare in its presentation at the age of 4 years with an enlarging accessory breast without any secondary sexual characters. Giant cell fibroblastoma in the accessory breast tissue is unreported yet. Case presentation A 4-year-old female child presented with a progressively enlarging accessory breast. A wide local excision of the accessory breast with underlying growth was done. The histopathological examination revealed a giant cell fibroblastoma within the breast tissue. Conclusions Enlargement of an accessory or normal breast at a prepubescent age with the absence of secondary sexual characters should arouse suspicion of benign tumors in the breast tissue.

Axillary Masses as Clinical Manifestations of Male Sweat Gland Carcinoma Associated with Extramammary Paget’s Disease and Accessory Breast Carcinoma: Two Cases Report and Literature Review

BackgroundAccessory breast carcinoma and sweat gland carcinoma associated with extramammary Paget’s disease of the axilla in male are rare cases. In clinical diagnosis and treatment, it is necessary to determine the disease carefully and make a reasonable treatment strategy according to the patient’s own situation.Case presentationWe reported two male cases of special tumor with axillary mass as initial clinical symptom, one was diagnosed as accessory breast cancer and the other was diagnosed as sweat gland cancer associated with extramammary Paget’s disease. We did personalized treatment for the two diseases, hoping to provide a reference for the diagnosis and management of diseases with axillary nodules as the initial symptoms.ConclusionsThe reports of these two cases have the potential to provide reference and corresponding thinking for clinical differentiation of axillary lymphadenopathy caused by different causes and subsequent treatment. These two cases may further enrich the database of rare cases and provide some ideas for the treatment of axillary lymphadenopathy caused by different causes.

Accessory breast cancer in the inframammary region: a case report and review of the literature

Background Although a few cases of accessory breast cancer (ABC) have been reported, most were in the axillary region. We encountered an extremely rare case of ABC in the inframammary region (IMR). Case presentation The patient was a 68-year-old postmenopausal woman who had noticed a congenital accessory nipple in her left IMR with slight, occasional discharge 20 years ago. Recently, she noticed a mass under the accessory nipple and visited a nearby clinic; fine-needle aspiration cytology of the mass revealed that it was malignant. She presented to our department 2 weeks after she had noticed the mass. Physical and imaging examinations showed an irregular tumor mass 1.7 × 1.4 × 1.0 cm in size connected to the accessory nipple beneath the left normal breast. Neither distant metastasis nor lymph node swelling was observed. Ultrasound-guided core needle biopsy revealed the mass to be invasive ductal carcinoma. We diagnosed her tumor as ABC in the left IMR; cT1cN0M0: stage IA. Curative wide resection with sentinel node biopsy was performed. Intraoperative evaluation of the frozen section revealed a hot and green ipsilateral axillary lymph node that was free from carcinoma; therefore, nodal dissection was avoided. Histopathological examination including immunochemical staining revealed that the tumor was invasive ductal carcinoma arising from the accessory breast tissue, scirrhous type, 1.7 × 1.4 × 1.0 cm in size, with a solid intraductal component. There was no lymphovascular infiltration, and the surgical margin was 1.5 cm or more. The tumor was estrogen and progesterone receptor-positive, Her2/neu-negative, and had a Ki-67 labeling index of 20%. There was no involvement of the three hot and/or green nodes. The final classification was pT1cN0(sn)M0: stage IA. Letrozole 2.5 mg/day will be administered for 5 years as adjuvant hormonal therapy. Conclusions A cutaneous and/or subcutaneous lesion except for proper breast tissue on the milk line, or mammary ridge from axilla to groin may be an accessory breast tissue. Its serial abnormalities must be worried malignant potential to ductal carcinoma which needs some imaging and pathological examinations for definitive diagnosis and appropriate treatment according to the usual orthotopic breast cancer without delay.

Fibroadenoma in a suprapubic accessory breast

Ectopic breast tissue (EBT) is relatively common and can occur along the milk line or mammary ridge and often outside this line. We report a case of a female patient presenting with a suprapubic mass for 2 years, found later to be EBT containing a fibroadenoma. We believe this is a very rare finding. Moreover, we highlight the importance of considering EBT in the differential diagnoses of soft tissue masses.

Male Triple Negative Axillary Accessory Breast Cancer, a Case Report

Background: Breast cancer is the most common malignancy among women worldwide. In men, cases of breast cancer are few and accounts for less than 1% of all cases of breast cancer. Majority of male breast cancer is hormone receptor-positive. The incidence of male axillary accessory breast cancer derived from axillary accessory breast is very low. Here we report a case of male triple negative axillary accessory breast cancer.Case presentation: We present a case of a male triple negative axillary accessory breast cancer in a 67-year-old man that progressively increased in size through a period of 1 year. We performed right accessory breast resection and right axillary lymph nodes dissection. Postoperative pathological analysis revealed right accessory breast invasive ductal carcinoma with apocrine metaplasia. The tumor size was 3.5 * 3.3cm. In addition, 5 metastatic lymph nodes were seen in 27 axillary lymph nodes. Immunohistochemistry showed ER (-), PR (-), Ki-67 30%, HER2 (2 +), GATA-3 (+), GCDFP-15(+), and AR (+). Fish test obtained a negative result. The patient was treated with adjuvant chemotherapy and radiotherapy.Conclusion: Male triple negative axillary accessory breast cancer is rare. Treatment of male triple negative axillary accessory breast cancer is similar to that of women patients. Most patients undergo surgery and adjuvant chemotherapy.

Case of second primary breast cancer in ectopic breast tissue and review of the literature

Accessory breast tissue (ABT) is found in approximately 2%–6% of the female population and are subject to most of the physiological and pathological changes that occur in pectoral breast. Primary breast cancer occurring in ABT is a rare occurrence and a second primary breast cancer occurring in an accessory breast has never been reported. We report the case of a 60-year-old woman with a history of mastectomy for left breast cancer 5 years prior to presentation, who presented with an enlarging right axilla mass found to be a second primary breast cancer in an accessory tissue on biopsy. Many physicians are unfamiliar with the clinical presentation of accessory breast cancer due to the rarity of the condition and this ultimately results in delayed diagnosis and advanced disease at presentation. It is therefore prudent that physicians have a high index of suspicion when patients present with axillary masses.

Diagnosis and Treatment of Male Accessory Breast Cancer: A Comprehensive Systematic Review

BackgroundAccessory breast cancer is extremely rare, especially in male patients, and only a few cases have been reported in the literature. To date, no specific guidelines regarding its diagnosis and treatment are available.ObjectivesThis study aimed to investigate the guidelines for the diagnosis and treatment of male accessory breast cancer by reviewing the available literature on this disease.MethodsThe Web of Science, Cochrane, PubMed, and CNKI databases were systematically searched (last search: 30 November 2020) to identify studies on male axillary accessory breast cancer. The following data were extracted: author names, number of patients, country, patient age, tumor location, tumor size, pathologic diagnosis, and treatment.ResultsThere were 16 studies included (6 in Chinese and 10 in English), corresponding to 16 cases of male axillary accessory breast cancer. Primary surgical resection is currently the main procedure, followed by comprehensive treatment including chemotherapy, radiotherapy, and endocrine therapy. Patient age ranged from 51–87 years, and the average age was 67.1 years. The main clinical features of the patients were pain, the portion of the skin covering the mass was either reddish or purplish, and the mass could show swelling and erosion on the surface, with purulent exudate.ConclusionsOnce male accessory breast cancer is diagnosed, we can follow the latest guidelines for the diagnosis and treatment of breast cancer. Tumor biopsy and resection seems the treatment of first choice, combined with comprehensive treatment including chemotherapy, radiotherapy, and endocrine therapy.