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乳腺基质生成癌在磁共振成像上显示晚期边缘持续强化。

Matrix-producing carcinoma of the breast showing retained rim enhancement to the late phase on magnetic resonance imaging.

作者信息

Yoshida Mami, Oura Shoji

机构信息

Department of Surgery, Kishiwada Tokushukai Hospital, Kishiwada-City, Japan.

出版信息

Radiol Case Rep. 2023 Oct 19;19(1):17-20. doi: 10.1016/j.radcr.2023.09.084. eCollection 2024 Jan.

Abstract

A 54-year-old woman with a left breast mass was referred to our hospital. Mammography showed a mass, 2.1cm in size, with micro-lobulated boarders. Ultrasonography showed an oval mass with predominant low internal echoes and enhanced posterior echoes. Core needle biopsy of the tumor showed malignant cells and chondroid matrices. With MRI, the tumor was hypo-intense on T1-weighted images, mixed hyper- and hypo-intense on T2-weighted images, and completely rim enhanced until late phase on time-signal intensity curve. Despite the good indication for breast conserving therapy, patient's preference made her undergo total mastectomy, sentinel lymph node biopsy, and immediate breast reconstruction using an extended latissimus dorsi musculocutaneous flap. Postoperative pathologic study showed large acellular areas, atypical cells growing in cord-like and linear fashions with cartilage-like matrices, and no spindle cells / osteoclasts between the cancer cells and chondroid matrices, leading to the pathologic diagnosis of matrix-producing carcinoma. The patient received dose-dense chemotherapy as an adjuvant therapy and has been well without any recurrences for 14 months. Physicians should note that partial hypo-intensity on T2-weighted images and retained rim enhancement to the late phase should be important findings of breast matrix-producing carcinoma.

摘要

一名54岁左侧乳腺有肿块的女性被转诊至我院。乳腺钼靶检查显示一个大小为2.1厘米、边界呈微叶状的肿块。超声检查显示为椭圆形肿块,内部回声以低回声为主,后方回声增强。肿瘤的粗针活检显示有恶性细胞和软骨样基质。磁共振成像(MRI)显示,肿瘤在T1加权图像上呈低信号,在T2加权图像上呈高信号与低信号混合,在时间-信号强度曲线上直至晚期均有完整的边缘强化。尽管保乳治疗指征良好,但患者的个人意愿使其接受了全乳切除术、前哨淋巴结活检,并立即使用背阔肌肌皮瓣进行乳房重建。术后病理研究显示大片无细胞区域,非典型细胞呈条索状和线性生长,伴有软骨样基质,癌细胞与软骨样基质之间未见梭形细胞/破骨细胞,病理诊断为产基质癌。该患者接受了剂量密集化疗作为辅助治疗,14个月来情况良好,无任何复发。医生应注意,T2加权图像上的部分低信号以及晚期持续存在的边缘强化是乳腺产基质癌的重要表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0e7d/10597748/8e640dfd5fb7/gr1.jpg

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