Khandelwal Rohan, Tandon Megha, Yashwant K, Kulshreshtha Pranjal, Aeron Tushar, Bhatnagar Dinesh, Bansal Anju, Saxena Sunita
Department of Surgery, Vardhman Mahavir Medical College, Safdarjang Hospital, New Delhi-110023, India.
Cases J. 2009 Dec 18;2:9348. doi: 10.1186/1757-1626-2-9348.
Malignant transformation of a fibroadenoma is rare with only about 100 cases reported in the world literature. Fibroadenoma occurring in middle aged woman with a strong family history of breast or ovarian cancer should be investigated with a high suspicion for malignancy.
A 35-year- old Indian lady operated previously for fibroadenoma of the right breast presented with a recurrent lump at the same site. She had a strong family history of breast carcinoma. Mammography and trucut biopsy was suggestive of infiltrating duct carcinoma. She was managed by lumpectomy and axillary lymph node dissection with a satisfactory outcome. There was no evidence of BRCA-1, BRCA-2 mutation on immunohistochemistry.
Malignant change in a pre-existing fibroadenoma is rare, however in a middle aged woman with a family history of breast cancer it should be suspected. In the absence of any definite clinical and radiological criteria of diagnosing malignant change in a fibroadenoma, high suspicion index is mandatory. The management and outcome depends on the stage and grade of presentation.
纤维腺瘤的恶性转化极为罕见，世界文献中仅报道了约100例。发生于有乳腺癌或卵巢癌家族史的中年女性的纤维腺瘤，应高度怀疑为恶性并进行检查。
一名35岁的印度女性，曾因右乳纤维腺瘤接受手术，现于同一部位出现复发性肿块。她有乳腺癌家族史。乳房X线摄影和粗针活检提示浸润性导管癌。她接受了肿块切除术和腋窝淋巴结清扫术，结果令人满意。免疫组织化学检查未发现BRCA-1、BRCA-2突变。
既往存在的纤维腺瘤发生恶性变很罕见，但对于有乳腺癌家族史的中年女性应予以怀疑。在缺乏诊断纤维腺瘤恶性变的确切临床和影像学标准的情况下，必须保持高度怀疑指数。治疗方法和结果取决于病变的分期和分级。
