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Desmoid fibromatosis of the breast

Case contributed by Gabriela Nicole Cepeda De Jesus
Diagnosis certain

Presentation

Palpable lump in the left breast.

Patient Data

Age: 65 years
Gender: Female
mammography

CC view of the left breast demonstrates a 10 mm asymmetry in the medial left breast posterior depth. No correlating abnormality on the MLO view.

ultrasound

Sonographic evaluation of the palpable area, demonstrates a 10 mm irregular hypoechoic mass with vertical orientation, in the lower inner quadrant of the left breast, in the 7 o'clock position, 10 cm from the nipple. There is a track to the skin. There is internal vascularity on color Doppler.

Case Discussion

This is a case of a 65-year-old female who presented for workup of a palpable mass in the left breast. Imaging features were suspicious for malignancy. The patient underwent a US-guided core biopsy with pathology consistent with desmoid fibromatosis of the breast. Immunohistochemical stain for Beta-catenin was strongly positive. The patient underwent surgical excision.

Desmoid fibromatosis of the breast is a rare and locally invasive benign tumor, resulting from abnormal proliferation of fibroblasts and myofibroblasts. Breast imaging findings are nonspecific and usually mimic malignancy. Standard treatment involves wide local excision.

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