Hara Yuki, Yano Hiroshi, Yamaguchi Rin, Iwasaki Keisuke
Department of Breast Surgery, Sasebo City General Hospital, Sasebo, Nagasaki 857-8511, Japan.
Department of Breast Surgery, Sasebo City General Hospital, Sasebo, Nagasaki 857-8511, Japan.
Int J Surg Case Rep. 2021 Dec;89:106544. doi: 10.1016/j.ijscr.2021.106544. Epub 2021 Nov 3.
A lactating adenoma is a benign breast tumor occurring in young women during pregnancy or lactation. Its growth is usually slow but, occasionally, can become rapid, resulting in a giant mass. This case report outlines an example of the rapid growth of a lactating adenoma, which was surgically excised. In this case, malignancy could not be ruled out, and biopsy and surgical excision were considered.
We present the case of a 28-year-old woman referred to us owing to the presence of a left breast mass with progressive enlargement. She initially presented with a left breast mass of approximately 20-mm in size, which increased to an approximate size of 70 mm during pregnancy. The patient's mammogram showed an equal-density lobular mass in the left breast. Ultrasonography and magnetic resonance imaging revealed a circumscribed lobular mass with cystic regions in the upper lateral quadrant. The patient was diagnosed with adenosis using core needle biopsy. However, it did not shrink during follow-up, and resection was performed. Histologically, the proliferation of the cystic ducts containing eosinophilic secretions and dilated tubules consisting of cuboidal or hobnail-shaped cells were observed.
Lactating adenoma, phyllodes tumor, and breast cancer are essential differential diagnoses when the size of breast masses increases rapidly. Ultrasonography is the first choice to examine lactating adenomas. Echogenic bands and pseudocapsules are characteristics of lactating adenomas.
Surgical excision is a notable treatment option when a lactating adenoma exhibits rapid growth or increase in mass, as it could be malignant.
泌乳性腺瘤是一种发生于年轻女性孕期或哺乳期的良性乳腺肿瘤。其生长通常缓慢，但偶尔也可能迅速增大，形成巨大肿块。本病例报告概述了一例泌乳性腺瘤迅速生长并经手术切除的病例。在此病例中，无法排除恶性可能，因此考虑进行活检和手术切除。
我们报告一例28岁女性病例，因左乳肿块进行性增大前来就诊。她最初左乳肿块大小约为20毫米，孕期增大至约70毫米。患者的乳房X线摄影显示左乳有一个等密度小叶肿块。超声检查和磁共振成像显示上外象限有一个边界清晰的小叶肿块，伴有囊性区域。患者经粗针活检诊断为腺病。然而，随访期间肿块未缩小，遂进行了切除。组织学检查发现含有嗜酸性分泌物的囊性导管增生以及由立方状或鞋钉状细胞组成的扩张小管。
当乳腺肿块迅速增大时，泌乳性腺瘤、叶状肿瘤和乳腺癌是重要的鉴别诊断对象。超声检查是检查泌乳性腺瘤的首选方法。回声带和假包膜是泌乳性腺瘤的特征。
当泌乳性腺瘤出现迅速生长或肿块增大时，手术切除是一项值得注意的治疗选择，因为其可能为恶性。
