El-Attrache BenFauzi, Gluck Bradley, Heimann Alan, Kapenhas Edna
Department of Surgery at Stony Brook Southampton Hospital, United States.
Department of Diagnostic Radiology at Stony Brook Southampton Hospital, United States.
Int J Surg Case Rep. 2018;52:137-139. doi: 10.1016/j.ijscr.2018.10.003. Epub 2018 Oct 8.
Rosai-Dorfman Disease (RDD) is a rare pathological finding in the breast. Although it is usually palpated as a breast mass, it can be identified on ultrasound or mammogram. The hallmark of the disease is histiocytes with emperipolesis. The case presented in this study represents the first known documented male breast recurrence of RDD and the first association of the disease with pseudoangiomatous stromal hyperplasia (PASH).
A 55-year-old male, with a prior history of right breast excisional biopsy of a mass in 2015 that showed RDD, presented to our breast clinic for follow up. A breast sonogram showed a hypoechoic mass. Biopsy and excision were performed revealing recurrent RDD along with PASH.
RDD is a benign condition that normally presents in lymph nodes but can present in extranodal sites, such as the breast. Location and symptoms guide treatment which can include medical or surgical therapy. PASH of the breast is a benign process that may be amenable to treatment by observation, medical management, or surgical excision. Treatment continues to be controversial given the lack of long term sequelae.
Definitive treatment for RDD of the breast and PASH has not been established. Based on the available data in the literature, our conclusion is that recurrent RDD of the breast can be observed without need for surgical therapy.
罗萨伊-多夫曼病(RDD)是乳腺中一种罕见的病理表现。尽管它通常可触及为乳腺肿块,但也可通过超声或乳房X线摄影发现。该病的标志是具有吞噬现象的组织细胞。本研究中呈现的病例是已知的首例记录在案的男性乳腺复发性RDD,也是该病首次与假性血管瘤样间质增生(PASH)相关联。
一名55岁男性,既往有2015年右侧乳腺肿块切除活检史,病理显示为RDD,现到我们的乳腺诊所进行随访。乳腺超声检查显示一个低回声肿块。进行了活检和切除,结果显示为复发性RDD伴PASH。
RDD是一种良性疾病,通常出现在淋巴结,但也可出现在结外部位,如乳腺。位置和症状指导治疗,治疗方法可包括药物或手术治疗。乳腺PASH是一个良性过程,可通过观察、药物治疗或手术切除进行治疗。鉴于缺乏长期后遗症,治疗仍存在争议。
乳腺RDD和PASH的明确治疗方法尚未确立。根据文献中的现有数据,我们的结论是,乳腺复发性RDD可以观察,无需手术治疗。