Johnson Joshua B, Emory Tim H
Radiol Case Rep. 2015 Dec 7;3(4):214. doi: 10.2484/rcr.v3i4.214. eCollection 2008.
Male breast cancer is a rare disease in the male breast whereas gynecomastia is quite common. An elevation of the estrogen-to-androgen ratio increases the risk of both of these diseases. However, a connection between gynecomastia and subsequent breast cancer development is controversial and unclear. Imaging studies including mammography and ultrasound provide valuable information in leading to a correct diagnosis. Traditionally, intracystic papillary carcinoma, also known as encapsulated papillary carcinoma, has been considered a form of ductal carcinoma in situ. Recent immunohistochemical studies, demonstrating an absence of myothelium, in many cases would be more compatible with the diagnosis of invasive malignancy. However, intracystic papillary carcinoma holds a favorable prognosis with local therapy alone. We report a case of intracystic papillary carcinoma in a male patient with long-standing gynecomastia diagnosed eight years prior by mammography. The patient presented with a breast lump on both occasions. Current work-up consisted of both mammography and ultrasound. Ultrasound provided key information revealing a complex mass requiring further evaluation. Ultrasound-guided core needle biopsy revealed intracystic papillary carcinoma with confirmation upon surgical excision.
男性乳腺癌是男性乳腺中的一种罕见疾病，而男性乳房肥大则相当常见。雌激素与雄激素比例的升高会增加这两种疾病的风险。然而，男性乳房肥大与随后发生乳腺癌之间的联系存在争议且尚不清楚。包括乳房X线摄影和超声在内的影像学检查在做出正确诊断方面提供了有价值的信息。传统上，囊内乳头状癌，也称为包膜内乳头状癌，一直被认为是导管原位癌的一种形式。最近的免疫组织化学研究表明，在许多病例中缺乏肌层，这与浸润性恶性肿瘤的诊断更相符。然而，囊内乳头状癌仅通过局部治疗就有良好的预后。我们报告一例男性囊内乳头状癌病例，该患者有长期男性乳房肥大病史，八年前通过乳房X线摄影确诊。患者两次均表现为乳腺肿块。目前的检查包括乳房X线摄影和超声。超声提供了关键信息，显示有一个复杂肿块需要进一步评估。超声引导下的粗针活检显示为囊内乳头状癌，手术切除后得到证实。
