Huang Yaoyu, Zhang Hao, Zhou Qian, Ling Lijun, Wang Shui
Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, Nanjing, Jiangsu, 210029, China.
Department of Breast Surgery, Nanjing Maternity and Child Health Care Hospital Affiliated to Nanjing Medical University, Nanjing, Jiangsu, China.
Diagn Pathol. 2015 Jun 4;10:60. doi: 10.1186/s13000-015-0286-0.
Tubular adenoma of the breast is a rare benign epithelial tumor and only a few literatures have been reported; so far, no cases of tubular adenoma occurred in the accessory breast have been reported in the English literature. Clinical presentation and management of our patient are discussed along with a review of the literature on accessory mammary and tubular adenoma.
We present a case of 26-year-old woman (gravid 4, para 1) at 37 weeks of pregnancy with rapid enlargement in left anterior chest wall during pregnancy. Physical examination showed the left accessory breast was obviously bigger than the right one that only had a light areola around a small nipple. An elastic, mobile well-circumscribed mass measuring approximately 15 cm × 15 cm was palpated. Moreover, it was edematous and congestive with an increase in local temperature. The breast ultrasound further demonstrated the mass was a relatively homogeneous solid with short stripe blood flow signal. A single live fetus of 37 weeks gestation was observed by abdominal ultrasound scan. After a 2850 g male neonate was delivered, the right accessory breast and the mass in left accessory breast were removed. The resected specimen appeared as a solid white elastic mass with a smooth surface and the cut surface was red-grayish. Microscopically, the lesion consisted of tightly packed homogenous glandular structures which are supported by a single layer of myoepithelial cells with sparse intervening stroma.
We describe a very rare case of giant tubular adenoma arising within an accessory breast in the anterior chest wall in a late pregnancy woman. The high concentrations of estrogen, progesterone and prolactin might account for the significant tumor enlargement during pregnancy. To our knowledge, this is the first case of giant tubular adenoma occurred within the accessory breast in the anterior chest wall.
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乳腺管状腺瘤是一种罕见的良性上皮性肿瘤，仅有少数文献报道；迄今为止，英文文献中尚未有副乳腺发生管状腺瘤的病例报道。本文结合对副乳腺和管状腺瘤的文献复习，讨论了我们患者的临床表现及处理。
我们报告一例26岁女性（孕4产1），妊娠37周时左前胸壁肿物迅速增大。体格检查显示左侧副乳腺明显大于右侧，右侧仅有围绕小乳头的浅色乳晕。触诊可及一个弹性、可活动、边界清晰的肿物，大小约为15 cm×15 cm。此外，肿物有水肿和充血，局部温度升高。乳腺超声进一步显示该肿物为相对均匀的实性肿物，伴有短条状血流信号。经腹部超声扫描观察到一个妊娠37周的单活胎。分娩出一名体重2850 g的男婴后，切除了右侧副乳腺及左侧副乳腺内的肿物。切除标本为实性白色弹性肿物，表面光滑，切面呈红灰色。显微镜下，病变由紧密排列的均匀腺管结构组成，由单层肌上皮细胞支撑，其间有稀疏的间质。
我们描述了一例非常罕见的巨大管状腺瘤，发生于一名晚期妊娠女性前胸壁的副乳腺内。孕期雌激素、孕激素和催乳素的高浓度可能是肿瘤在孕期显著增大的原因。据我们所知，这是首例发生在前胸壁副乳腺内的巨大管状腺瘤。
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