SONOWORLD : Inflammatory pseudotumor of the breast

Username

Password

163,517 Registered Members as of 04/22/2018.

JavaScript must be enabled in order for you to use Sonoworld.com in standard view. However, it seems JavaScript is either disabled or not supported by your browser. To use standard view, enable JavaScript by changing your browser options, then try again.

Breast » Breast

Inflammatory pseudotumor of the breast

« Back to Listing

Presentation A 66-year-old woman presented with pain and swelling in her breast of 4 years duration. Breast imaging examinations from 2003 and 2004 are illustrated.

Caption: Cranio-caudal mammograms -year 2003

Description: A small nodule is seen in the right breast that is suspicious for malignancy. The left breast reveals a normal parenchymal architecture.

Caption: Comparative medio-lateral oblique views -year 2003

Description: The nodule is noted again in the upper quadrant of the right breast. The left breast appears normal.

Caption: Cranio-caudal views performed the subsequent year

Description: Post surgical changes are seen in the right breast as a result of removal of the nodule seen in images of the year 2003. The right breast now shows the development of a new nodule. The left breast shows 2 new nodules that were not seen previously.

Caption: Medio-lateral oblique views

Description: Post surgical changes are seen in the right breast. The appearance of new nodules in both the breasts as described previously is noted.

Caption: Ultrasound of one of the newly detected nodules

Description: Sonograms of all masses show solid masses with characteristics of malignancy.

Caption: Medio-lateral oblique views

Description: Post surgical changes are seen in the right breast. The appearance of new nodules in both the breasts as described previously is noted.

Differential Diagnosis Malignancy, inflammatory pseudotumor

Final Diagnosis Inflammatory pseudotumor

Discussion • Pertinent History: Approximately 20yrs ago, the patient experienced a pulmonary embolus and was treated with warfarin. She has recently been self medicating with large doses of Vitamin E 4000-8000 IU per day. The biopsy specimens had revealed fat necrosis and recent hemorrhage secondary to Vitamin E ingestion.
• The imaging and pathologic findings are compatible with Vitamin E induced hemorrhagic necrosis of the breast.
• To our knowledge this has not been reported in the literature, but has been submitted for publication by Vrcel et al from the Moffitt Cancer Center.

Case References 1. Belli P et al. Role of magnetic resonance imaging in the diagnosis of recurrence after breast conserving therapy. Rays. 2002 Oct-Dec; 27(4) 241-57
2. Ringberg et al. Ipsilateral local recurrence in relation to therapy and morphological characteristics in patients with ductal carcinoma in situ of the breast. Eur J Surg Oncl. 2000 Aug;26 (5) 444-51
3. Robyn L Birdwell and Roger J Jackman. Clip or marker migration 5-10 weeks after stereotactic 11 guage vacuum assisted breast biopsy – Report of 2 cases. Radiology 2003 229: 541-544

Follow Up Biopsies were performed in 2003 and 2004. The pathological diagnosis was inflammatory pseudotumor. Review of the pathology was made after further history was obtained from the patient.

Other contents by this AuthorOther Cases in This Category

Breast >> Breast

Breast cyst in a teenage girl.
This 14 year old girl presented with a small palpable, painful mass in the left breast.

Breast carcinoma with metastases to axilla
A 40-year-old woman presents with a hard lump in the right breast. There was palpable right axillary lymphadenopathy. The following are the ultrasound images of the mass and the axillary node.

Breast ductal carcinoma
A 50-year-old woman presents with a lump in the right breast. An ultrasound was performed.

Focal mastitis
A 32-year-old lactating woman presents with severe localized pain in her left breast and fever for 2 days. An ultrasound of the breast was performed.

Fibroadenoma of the breast
A 25-year-old woman presents with a mobile breast mass. Mammography and sonomammography were performed.

Intraductal carcinoma
A 40-year-old woman presents with a hard and immobile lump in her breast. A mammogram and ultrasound of the mass was performed.

Recurrent carcinoma of the breast at lumpectomy site
Patient for follow-up;status post lumpectomy for carcinoma of the right breast.

Angiosarcoma of the breast
A 57-year-old woman presented with a recently palpable mass in the left breast. Prior yearly screening mammograms have been negative. Patient has a history of Hodgkins disease treated ...

Carcinoma in ectopic breast tissue
A 36-year-old woman presents with a mass in the right axilla. Mammogram and ultrasound examination was performed.

Breast hamartoma
A 35-year-old woman presented with a palpable mass in her right breast. A mammogram and ultrasound were performed.

Breast abscess
A young lactating woman presents with severe pain and reddish area behind and around the left nipple. An ultrasound of the left breast was performed.

Fibroadenolipoma of the breast
This is the scan in a 31-year-old nulliparous woman with a lump in her left breast. She has a positive family history of breast cancer.