Chen Wenyi, Zhang Huan, Huang Jiayan, Li Yixuan, Zhang Zhang, Peng Yulan
Department of Ultrasound.
Department of Pathology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
Medicine (Baltimore). 2019 Apr;98(15):e15142. doi: 10.1097/MD.0000000000015142.
Traumatic neuroma is a reparative proliferative response of the nerve after trauma or surgery, which rarely occurs in the breast. However, it must be distinguished from tumor recurrence.
A 78-year-old woman underwent left-sided modified radical mastectomy for invasive carcinoma, 7 years before this case. Two painless nodules near the mastectomy scar were discovered in regular follow-up physical examination. A 62-year-old woman had received right-sided modified radical mastectomy for intraductal carcinoma, 4 years before this case. An asymptomatic nodule near the mastectomy scar was detected during follow-up ultrasound (US) examination.
The lesions in both patients were diagnosed as traumatic neuroma.
The first patient underwent excisional biopsy. The second patient underwent US guided core-needle aspiration, followed by conservative therapy.
Neither patient complained of any discomfort, nor both exhibited normal physical and US findings during follow-up examinations.
Newly discovered nodules with the benign imaging features near the mastectomy site of a patient, especially with the tail sign, traumatic neuromas should be taken into consideration. Routine US examination is important for follow-up of breast cancer patients who have undergone mastectomy.
创伤性神经瘤是神经在创伤或手术后的一种修复性增殖反应,很少发生于乳腺。然而,它必须与肿瘤复发相鉴别。
本例患者中,一名78岁女性7年前因浸润性癌接受了左侧改良根治性乳房切除术。在定期随访体格检查中,于乳房切除瘢痕附近发现两个无痛性结节。另一名62岁女性4年前因导管内癌接受了右侧改良根治性乳房切除术。在随访超声检查中,于乳房切除瘢痕附近检测到一个无症状结节。
两名患者的病变均诊断为创伤性神经瘤。
第一名患者接受了切除活检。第二名患者接受了超声引导下粗针穿刺活检,随后进行了保守治疗。
两名患者在随访检查期间均未诉任何不适,体格检查和超声检查结果均正常。
对于乳房切除部位附近新发现的具有良性影像学特征的结节,尤其是伴有“尾征”的结节,应考虑创伤性神经瘤。常规超声检查对于接受乳房切除术的乳腺癌患者的随访很重要。