Tekbas Guven, Ince Tülay, Kapan Murat, Ekici Faysal, Onder Akin, Kucukonen Mehmet, Bilici Aslan, Gumus Hatice
Department of Radiology, Dicle University School of Medicine, Diyarbakir, Istanbul.
Breast Care (Basel). 2012 Apr;7(2):144-146. doi: 10.1159/000337770. Epub 2012 Apr 24.
This article is concerned with the evaluation of an adolescent breast mass using imaging methods. CASE REPORT: A 14-year-old girl presented with progressive asymmetric enlargement of the left breast. She had felt a breast lump about 4 months earlier, and over the last 2 months it had been growing progressively. Tumor markers, including AFP, CEA, CA15-3, and CA125, were all normal. Ultrasonography showed a hypoechoichyperechoic, solid mass. Magnetic resonance imaging of the breast revealed a well marginated mass with hypointensity on T1-weighted images and mild hyperintensity on T2-weighted images, which showed mild contrast uptake. Biopsy revealed an undifferentiated malignant mesenchymal sarcoma. The patient underwent mastectomy with axillary lymph node sampling. After the operation, she received 3 cycles of chemotherapy and radiotherapy. CONCLUSION: Due to the rarity of breast sarcoma and inadequate imaging methods to establish an exact diagnosis, radiologists and clinicians may misdiagnose and merely follow these tumors. As in our case, the histology of the patient may be the leading factor in the management of these tumors. Even in very young patients, progressively growing breast masses should alert the clinician to check for malignancy verified by biopsy.
本文关注使用影像学方法评估青少年乳腺肿块。病例报告：一名14岁女孩出现左侧乳腺进行性不对称增大。她大约4个月前感觉到乳腺有肿块，在过去2个月里肿块逐渐增大。肿瘤标志物，包括甲胎蛋白（AFP）、癌胚抗原（CEA）、糖类抗原15 - 3（CA15 - 3）和糖类抗原125（CA125）均正常。超声检查显示为低回声高回声实性肿块。乳腺磁共振成像显示一个边界清晰的肿块，在T1加权图像上呈低信号，在T2加权图像上呈轻度高信号，有轻度对比剂摄取。活检显示为未分化恶性间叶肉瘤。患者接受了乳房切除术及腋窝淋巴结采样。术后，她接受了3个周期的化疗和放疗。结论：由于乳腺肉瘤罕见且缺乏能确切诊断的影像学方法，放射科医生和临床医生可能会误诊并仅对这些肿瘤进行随访观察。就像我们这个病例一样，患者的组织学检查结果可能是处理这些肿瘤的主要因素。即使是非常年轻的患者，进行性增大的乳腺肿块也应提醒临床医生通过活检检查是否为恶性肿瘤。
