Villarreal-Colin SP, Soto-Dávalos BA, Bargalló-Rocha JE, Bandera-Delgado A, Zumaran-Cuéllar O, Robles-Vidal CD

Language: Spanish
References: 10
Page: 169-171
PDF size: 95.39 Kb.

ABSTRACT

Background: Breast fibromatosis (BF) is a rare benign pathological entity. Its etiology is unknown, but it has been associated with surgical trauma and certain genetic disorders.
Clinical cases: Case 1. The patient was a 17-year-old female with a 20 ´ 15 cm firm and fixed mass in the right breast. A core-needle biopsy was taken with a pathology report of a phyllodes tumor. Mastography revealed a well-differentiated lesion with no evidence of muscle invasion. The patient underwent wide surgical resection with thoracotomy and chest wall resection of the affected ribs. Pathology reported a 19 ´ 18 ´ 9 cm BF with a positive surgical margin. Oral colchicine was administered and at 3 months of follow-up the patient is disease free. Case 2. The patient was a 49-year-old female with a 7 ´ 5 cm solid right breast mass that was located at the medial-upper quadrant and fixed to the pectoralis major muscle. Mastography and magnetic resonance imaging revealed a mass infiltrating thoracic muscles. Wide surgical resection was performed with immediate latissimus dorsi reconstruction. Pathology report showed a BF with muscle invasion. At 3 months postsurgery, the patient is disease free.
Conclusions: BF is a rare entity with a locally aggressive behavior. The infiltrative nature of this disease is associated with a tendency to recur locally. Its clinical and imaging features can mimic breast cancer. Differential diagnosis should be made before attempting treatment. The standard therapeutic modality is wide surgical resection, and radiotherapy is reserved in some cases with positive surgical margins.

REFERENCES

1. 1. Matherne TH, Green A Jr, Tucker JA, Dyess DL. Fibromatosis: the breast cancer imitator. South Med J 2004;97:1100-1103.

2. 2. Povoski SP, Marsh WL, Spigos DG, Abbas AE, Brentley AB. Management of a patient with multiple recurrences of fibromatosis (desmoid tumor) of the breast involving the chest wall musculature. W J Surg Oncol 2006;4:32.

3. 3. Kulaylat M, Karakouisi C, Keaney C, Bem J, Ambrus J. Desmoid tumour: a pleomorphic lesion. Eur J Surg Oncol 1999 ;25 :487-497.

4. 4. Simpson RD, Harrison EG Jr, Mayo CW. Mesenteric fibromatosis in familial polyposis: a variant of Gardner’s syndrome. Cancer1964;17:526-534.

5. 5. Schwarz GS, Drotman M, Rosenblatt R, Milner L, Shamonki J, Osborne MP. Fibromatosis of the breast: case report and current concepts in the management of an uncommon lesion. Breast J 2006;12:66-71.

6. 6. Mesurolle B, Ariche-Cohen M, Mignon F, Piron D, Goumot PA. Unusual mammographic and ultrasonographic findings in fibromatosis of the breast. Eur Radiol 2001;11:2241-2243.

7. 7. Greenberg D, McIntyre H, Ramsaroop R, Arthur J, Harman J. Aggressive fibromatosis of the breast: a case report and literature review. Breast J 2002:8;55-57.

8. 8. Aaron AD, O’Mara JW, Legendre KE, Evans SR, Attinger CE, Montgomery EA. Chest wall fibromatosis associated with silicone breast implants. Surg Oncol 1996;5:93-99.

9. 9. Brooks MD, Ebbs SR, Colletta AA, Baum M. Desmoid tumors treated with triphenylethylenes. Eur J Cancer 1992;6/7:1014-1018.

10. 10. Papantoniou V, Koitsikos J, Feida E, Tsiouris S. Recurrent bilateral mammary fibromatosis (desmoid tumor) imaged with technetium-99m pentavalent dimercaptosuccinic acid scintimammopgraphy. Gynecol Oncol 2005;97:964-969.