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Imaging Findings of Nodular Fasciitis in Breast including Artificial Intelligence Mammography and Shear Wave Elastography: A Case Report (유방의 결절성 근막염의 인공지능 유방촬영술과 탄성초음파를 포함한 영상 소견: 증례 보고)

  • So Hyeong Park;Ji Yeon Park;Mee Joo;Jae Il Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.6
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    • pp.1397-1402
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    • 2023
  • Nodular fasciitis is a benign fibroblastic proliferation rarely reported in the breast. We report the case of a 55-year-old woman who presented with imaging findings that resembled a malignancy. Mammography revealed an isodense nodule with partially indistinct margin in the right breast, showing the abnormality score 75% on artificial intelligence. Ultrasonography revealed an oval hypoechoic nodule with microlobulated margin, echogenic halo, increased blood flow, and soft elasticity. After core needle biopsy and excision, nodular fasciitis was diagnosed. Although nodular fasciitis of the breast is rare, it may mimic malignancy; therefore, it should be considered as a differential diagnosis to prevent unnecessary intervention.

Granular Cell Tumor of the Axillary Accessory Breast: A Case Report (액와부 부유방에 발생한 과립 세포 종양: 증례 보고)

  • Youn Joo Jung;Kyung Jin Nam;Ki Seok Choo;Kyeyoung Lee
    • Journal of the Korean Society of Radiology
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    • v.84 no.1
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    • pp.275-279
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    • 2023
  • Granular cell tumors (GCTs) are rare benign soft tissue tumors that can occur throughout the body, particularly the head and neck; only 5%-8% of GCTs occur in the breast. We report a case of a GCT of the axillary accessory breast, which is a rare location of this tumor. A 50-year-old woman had a 2-month history of a palpable mass in the left axilla. Physical examination, as well as mammographic and ultrasonographic findings suggested a breast malignancy. Histopathological examination showed a benign GCT, and wide local excision was performed. The patient has remained disease-free over 2 years postoperatively. Although most GCTs are benign, wide complete resection of the tumor and follow-up are required considering the possibility of recurrence. The radiologist should know the characteristics of GCTs as a differential diagnosis of breast and axillary lesions to prevent unnecessary treatment.

Primary Malignant Melanoma of the Breast Presenting as a Breast Abscess: A Case Report (유방 농양으로 발현한 유방의 원발성 악성 흑색종: 증례 보고)

  • Hyung In Choi;You Me Kim;Junwon Min;Yong Moon Lee;Hee Jeong Kim
    • Journal of the Korean Society of Radiology
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    • v.84 no.3
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    • pp.763-769
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    • 2023
  • Primary malignant melanoma in breast parenchyma (PMB) is an extremely rare disease, and the most common presentation is a palpable breast lump. To the best of our knowledge, a case of PMB presenting as a breast abscess has not been reported in English literatures. We present a case of PMB that manifested as a recurrent breast abscess in a 71-year-old woman. On MRI, an enhancing solid mass with a cystic or necrotic portion was revealed with some high signal intensities on precontrast-enhanced T1-weighted images and a dark rim on T2-weighed images. The MRI features played a pivotal role in identifying the underlying malignant condition and making an accurate diagnosis of this rare case of PMB with unusual clinical presentation.

Solid pseudopapillary epithelial neoplasm of pancreas in pregnancy: A case report and review of literature

  • R K Hanumantha Naik;Anbalagan Amudhan;ArunKumar Ashokkumar;Anbarasu Inbasekaran;Selvaraj Thangasamy;Jeswanth Sathyanesan
    • Annals of Hepato-Biliary-Pancreatic Surgery
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    • v.28 no.1
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    • pp.92-98
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    • 2024
  • The solid pseudopapillary epithelial neoplasm (SPEN) of the pancreas is an uncommon tumor that accounts for approximately 1%-2% of exocrine pancreatic neoplasms. It predominantly affects female in their second and third decades of life. In this case report, we present a clinical scenario of a 21-year-old pregnant woman who incidentally discovered a solid cystic lesion in her pancreas, exhibiting features suggestive of SPEN. The patient underwent surgery during the second trimester. Management of pregnant females with SPEN poses challenges due to the absence of definitive treatment guidelines, particularly in determining the ideal timing for surgical intervention. Notably, during pregnancy, the presence of a small SPEN does not necessarily require immediate resection. However, if the tumor is of significant size, it can give rise to complications such as tumor rupture, multivisceral resection, recurrence, spontaneous abortion, intrauterine growth restriction, or premature delivery if not addressed. In the existing literature, a common finding is that approximately two-thirds of pregnant females with SPEN underwent surgery in the second trimester, often without complications for the mother or fetus. All these tumors were larger than 8 cm. The decision to operate before or after birth can be individualized based on team discussion. However, delay in surgery may lead to larger tumors and higher risks like bleeding, rupture, multivisceral resection, and recurrence. Therefore, second-trimester surgery seems safer, and lessens dangers, emergency surgery, and tumor recurrence.

Assessment of risks for breast cancer in a flight attendant exposed to night shift work and cosmic ionizing radiation: a case report

  • Dong Joon Park;Sungkyun Park;Seong Won Ma;Hoekyeong Seo;Sang Gil Lee;Kyung-Eun Lee
    • Annals of Occupational and Environmental Medicine
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    • v.34
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    • pp.5.1-5.10
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    • 2022
  • Background: Some epidemiological studies have estimated exposure among flight attendants with and without breast cancer. However, it is difficult to find a quantitative evaluation of occupational exposure factors related to cancer development individually in the case of breast cancer in flight attendants. That is, most, if not all, epidemiological studies of breast cancer in flight attendants with quantitative exposure estimates have estimated exposure in the absence of individual flight history data. Case presentation: A 41-year-old woman visited the hospital due to a left breast mass after a regular check-up. Breast cancer was suspected on ultrasonography. Following core biopsy, she underwent various imaging modalities. She was diagnosed invasive ductal carcinoma of no special type (estrogen receptor positive in 90%, progesterone receptor positive in 3%, human epidermal growth factor receptor 2/neu equivocal) with histologic grade 3 and nuclear grade 3 in the left breast. Neoadjuvant chemotherapy was administered to reduce the tumor size before surgery. However, due to serious chemotherapy side effects, the patient opted for alternative and integrative therapies. She joined the airline in January, 1996. Out of all flights, international flights and night flights accounted for 94.9% and 26.2, respectively. Night flights were conducted at least four times per month. Moreover, based on the virtual computer program CARI-6M, the estimated dose of cosmic radiation exposure was 78.81 mSv. There were no other personal triggers or family history of breast cancer. Conclusions: This case report shows that the potentially causal relationship between occupational harmful factors and the incidence of breast cancer may become more pronounced when night shift workers who work continuously are exposed to cosmic ionizing radiation. Therefore, close attention and efforts are needed to adjust night shift work schedules and regulate cosmic ionizing radiation exposure.

Secondary Breast Burkitt Lymphoma Involving the Stomach, Ovary, Pancreas, and Bones: A Case Report (전신의 다발성 침범을 동반한 이차성 유방 버킷 림프종: 증례 보고)

  • Hyun Ji Lee;Gi Won Shin;Young Mi Park;Minji Shin;Jin Hee Park;Ha Young Park
    • Journal of the Korean Society of Radiology
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    • v.85 no.4
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    • pp.807-812
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    • 2024
  • Breast lymphomas are rare, malignant breast neoplasms with a heterogeneous pattern of clinical symptoms. Burkitt's lymphoma is a rare, highly aggressive, and rapidly growing B-cell non-Hodgkin lymphoma. We report about a 27-year-old woman diagnosed as having secondary breast Burkitt's lymphoma, probably originating from the stomach, with multiple distant metastases. Breast ultrasonography revealed multiple, variable sized, heterogeneous masses with posterior acoustic enhancement and echogenic rims. These imaging findings may sometimes overlap with those of other breast malignancies. However, unlike other breast malignancies, lymphoma can be diagnosed by biopsy and does not require surgical excision. To avoid unnecessary treatment, radiologists and clinicians should be aware of the characteristic imaging features of breast lymphomas.

Symptomatic perianeursymal cyst development 20 years after endovascular treatment of a ruptured giant aneurysm: Case report and updated review

  • Amy J. Wang;Justin E. Vranic;Robert W. Regenhardt;Adam A. Dmytriw;Christine K. Lee;Cameron Sadegh;James D. Rabinov;Christopher J. Stapleton
    • Journal of Cerebrovascular and Endovascular Neurosurgery
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    • v.26 no.2
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    • pp.187-195
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    • 2024
  • Perianeurysmal cysts are a rare and poorly understood finding in patients both with treated and untreated aneurysms. While the prior literature suggests that a minority of perianeurysmal cysts develop 1-4 years following endovascular aneurysm treatment, this updated review demonstrates that nearly half of perianeurysmal cysts were diagnosed following aneurysm coiling, with the other half diagnosed concurrently with an associated aneurysm prior to treatment. 64% of perianeurysmal cysts were surgically decompressed, with a 39% rate of recurrence requiring re-operation. We report a case of a 71-year-old woman who presented with vertigo and nausea and was found to have a 3.4 cm perianeurysmal cyst 20 years after initial endovascular coiling of a ruptured giant ophthalmic aneurysm. The cyst was treated with endoscopic fenestration followed by open fenestration upon recurrence. The case represents the longest latency from initial aneurysm treatment to cyst diagnosis reported in the literature and indicates that the diagnosis of perianeurysmal cyst should remain on the differential even decades after treatment. Based on a case discussion and updated literature review, this report highlights proposed etiologies of development and management strategies for a challenging lesion.

Surgery-early approach combined with condylectomy for correction of severe facial asymmetry with mandibular condylar hyperplasia: a case report

  • Hikari Suzuki;Shinnosuke Nogami;Yoshio Otake;Yuri Takeda;Junji Sugawara;Tetsu Takahashi;Kensuke Yamauchi
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.50 no.4
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    • pp.227-234
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    • 2024
  • In patients with unilateral mandibular condyle hyperplasia, whether to perform condylectomy and orthognathic surgical procedures at the same time or orthognathic surgery in two stages for remains controversial. Reported here is a case of facial asymmetry with mandibular condyle hyperplasia, for which condylectomy and orthognathic surgery procedures were performed at the same time. A 28-year-old woman was presented to our department with chief complaints of left deviation of the mandible and right temporomandibular joint (TMJ) noise. Findings obtained in several imaging examinations led to a diagnosis of facial asymmetry associated with right mandibular condyle hyperplasia. Following 3 months of preoperative orthodontic treatment, in October 2018 under general anesthesia the patient underwent a right mandibular condylectomy, Le Fort I osteotomy, right mandibular sagittal split ramus osteotomy, and left mandibular inverted L ramus osteotomy. In examinations up to 3 years after surgery, good results were noted. For this case of severe facial asymmetry with mandibular condyle hyperplasia, early surgery and condylectomy were performed simultaneously to significantly shorten the total treatment time. The effectiveness of a surgery-early approach was confirmed by no postoperative findings indicating abnormalities in the TMJ or retroversion.

Study for Relationship between the Type of Differentiation of Symptoms and Signs of Oriental Gynecology and Sasang Constitution (In the Field of the Patiehts who chiefly complained Feeling of Cold) (부인과(婦人科) 냉증환자(冷症患者)의 변증유형(辨證類型)과 사상체질(四象體質)과의 관계에 대한 소고(小考))

  • Lee, In-seon;Kim, Jong-weon;Lee, Sang-hoon
    • Journal of Sasang Constitutional Medicine
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    • v.9 no.2
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    • pp.263-281
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    • 1997
  • We studied the relationship between each type which was figured out by the question paper given to the patients who chiefly complained feeling of cold and Sasang constitution. The results are as follows. 1. Diagnoses in woman's disease with feeling of cold(冷病) are abdomnal mass(uterine myoma, ovarian cyst), dysmenorrhea, leukorrhea and infertility, orderly in number. They have commoness in the origin of disease which are stagnation of Qi(氣滯) and blood stasis(血瘀), cold(寒), damp(濕) and we can find the causes of feeling of cold are stagnation of blood(血瘀) and harmness of damp(水毒). 2. In the type of survey through the question paper, the largest number of the origin of that disease is cold, the next is blood stasis and dificiency of Qi(氣虛), dificiency of blood(血虛), stagnation of Qi, damp phlegm(濕痰) etc. 3. (1)The numbers by constitutional assortment of object are like this. Taeumin are 23 persons,Soumin 14 and Soyangin 6, so we can find the feeling of cold turn up evenly in all constitution but the number of Soyangin was relatively small. (2)The inclination of constitutional type is the highest in Soumin and they often have and feel strongly disorders of their body. (3)We could find the corelation of theoretical background of Sasang Medicine in constitutional type of survey. 4. (1)The numbers by constitutional assortment of the patients with feeling of cold and numbness(冷痺症) are like this. Taeumin are 16 persons, Soumin 7 and Soyangin 3, as are like the distribution of 3-(1). (2)The inclination of constitutional type is the highest Soumin, so they have multiple type of differentiation of symptoms and signs and their symptoms is old and severe, therefore they need long time for cure. In all, except the symptom with feeling of cold caused by dificiency of the blood and insufficiency of yang(氣虛와 陽虛) that we meet frequently on clinic is numerous, the number of that caused by stagnation of Qi and blood(氣滯와 血滯) alike dysautonomia is also large. And we can find the feeling of cold turn up evenly in all constitution but the number of Soyangin was relatively small. Within the case of Soumin, they have both dificiency of Qi and blood, have complex source, so their symptoms are old and severe and they need long time for cure. In Taeumin, they are of large number with dificiency of Qi and we think thst that are concerned with the symptom of exterior cold.

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Meningeal Hemangiopericytoma Treated with Surgery and Radiation Therapy - Case Report - (수막 혈관주위세포종 환자에서의 수술과 방사선치료 -증례보고-)

  • Jang Ji-Young;Oh Yoon-Kyeong
    • Radiation Oncology Journal
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    • v.24 no.2
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    • pp.149-155
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    • 2006
  • Meningeal hemangiopericytoma (HPC) is an uncommon dura-based tumor and can recur not only locally but also distantly in the neural axis or extraneural sites. We report our experience of radiation therapy, one preoperative and one elective postoperative, In two patients with meningeal HPC and reviewed the role of radiation therapy. A 41-year-old man (Case 1) presented with a 3-month history of headache and right hemiparesis. The mass was nearly unresectable at the first and second operation and diagnosed as meningeal HPC. Preoperative radiation therapy was given with a total dose of 55.8 Gy/31 fractions to the large residual mass of left frontoparietal area. Follow-up computerized tomography (CT) showed marked regression of tumor after radiation therapy. The third operation was peformed to remove the residual tumor at 6 months after the radiation therapy and a $2{\times}2cm$ sized tumor was encountered. The mass was totally removed. The serial follow-up CT showed no evidence of recurrence and he is alive without distant metastasis for 4 years and 10 months after the first operation. A 45-year-old woman (Case 2) presented with suddenly developed headache and visual impairment. Tumor mass occupying right frontal lobe was removed with the preoperative diagnosis of meningioma. It was totally removed with attached sagittal sinus and diagnosed as meningeal HPC. Elective postoperative radiation therapy was peformed to reduce local recurrence with a total dose of 54 Gy/30 fractions to the involved area of right frontal lobe. She is alive for 5 years maintaining normal activity without local recurrence and distant metastasis.