Cheng Shirley, Lau-Amii Briana
John A. Burns School of Medicine, University of Hawai'i, 651 Ilalo St., Honolulu, HI 96813, USA.
Kaiser Permanente Moanalua Medical Center, 3288 Moanalua Rd., Honolulu, HI 96819, USA.
Radiol Case Rep. 2023 Feb 10;18(4):1564-1569. doi: 10.1016/j.radcr.2023.01.047. eCollection 2023 Apr.
Nodular fasciitis (NF) is a benign soft tissue lesion that can occur anywhere in the body. Its occurrence in the breast is a rare phenomenon, but is clinically important to distinguish from a malignant tumor as they both present as lesions of the breast. In this report, we discuss a case of NF of the breast in an postmenopausal woman who presented with an asymmetry of the breast on an annual screening mammogram followed by diagnostic imaging and a core biopsy. Ultimately, excision of the lesion (1.2 cm) was the definitive treatment for this patient and histological evaluation confirmed the diagnosis of NF. Additionally, we review the most recent literature on this topic discussing the significance to better understand the characteristics and best treatment course for breast NF. Results from a review of 11 breast NF cases demonstrated that the average age at diagnosis is 49, the mean diameter of lesions was 1.33 cm, and lesions were more frequently identified in the right upper breast. The clinical features of breast NF may present similarly to that of a malignant tumor. Accurate diagnosis with immunohistochemistry staining or USP6 FISH analysis is critical to prevent misdiagnosis and overtreatment. Clinician awareness, surgical treatment, and patient education are important for best management of breast NF.
结节性筋膜炎(NF)是一种可发生于身体任何部位的良性软组织病变。其在乳腺中的发生较为罕见,但在临床上区分它与恶性肿瘤很重要,因为二者在乳腺中均表现为病变。在本报告中,我们讨论了一例绝经后女性乳腺结节性筋膜炎病例,该患者在年度筛查乳腺钼靶检查中发现乳腺不对称,随后进行了诊断性影像学检查和粗针活检。最终,切除该病变(1.2厘米)是该患者的确定性治疗方法,组织学评估证实了结节性筋膜炎的诊断。此外,我们回顾了关于该主题的最新文献,讨论其意义,以更好地了解乳腺结节性筋膜炎的特征和最佳治疗方案。对11例乳腺结节性筋膜炎病例的回顾结果表明,诊断时的平均年龄为49岁,病变的平均直径为1.33厘米,且病变更常见于右上象限乳腺。乳腺结节性筋膜炎的临床特征可能与恶性肿瘤相似。通过免疫组织化学染色或USP6荧光原位杂交分析进行准确诊断对于防止误诊和过度治疗至关重要。临床医生的认知、手术治疗和患者教育对于乳腺结节性筋膜炎的最佳管理很重要。