乳腺原发性黏液性囊腺癌的影像学特征:病例报告及文献复习

Imaging Characteristics of Primary Mucinous Cystadenocarcinoma of the Breast: A Case Report and Literature Review.

作者信息

Bian Yizhong, Xu Lei, Zhou Yibo, Li Jizhen

机构信息

Department of Ultrasound Medicine, Affiliated Jinhua Hospital Zhejiang University School of Medicine, Jinhua, Zhejiang, 32100, P. R. China.

Department of Pathology, Affiliated Jinhua Hospital Zhejiang University School of Medicine, Jinhua, Zhejiang, 32100, P. R. China.

出版信息

Curr Med Imaging. 2025;21:e15734056345716. doi: 10.2174/0115734056345716241213075234.

Abstract

INTRODUCTION

Mucinous Cystadenocarcinoma (MCA) of the breast remains a relatively rare condition, and to date, there is no systematic summary of its imaging manifestations. Therefore, this report presents a detailed account of the diagnosis and treatment of mucinous cystadenocarcinoma in a 40-year-old woman, with a particular focus on imaging findings. Additionally, we conducted a comprehensive literature review on this disease and summarized its key imaging features. This manuscript provides valuable insights and methodologies for the accurate diagnosis of mucinous cystadenocarcinoma.

CASE PRESENTATION

We report a 40-year-old premenopausal woman who discovered multiple cysts in her left breast five years ago. Over the past two years, the size of these tumors has increased. Ultrasound examination indicated that the cysts had grown to 27 x 17mm. Following a puncture, the cysts were confirmed to be benign and were not monitored regularly. A year later, the patient's mass in the left breast increased, and an ultrasound exam indicated a suspicious mixed echo area in the upper outer quadrant, suggestive of a malignant lesion. Mammography showed amorphous suspicious calcifications in the lesion area, distributed in segments. Contrast-enhanced magnetic resonance imaging displayed non-mass-type enhancement of the lesion, with a dynamic enhanced imaging time-signal intensity curve (TIC) showing a rapidly rising plateau pattern. Postoperative pathology confirmed invasive carcinoma of the left breast along with mucinous cystadenocarcinoma. Four months after surgery, the patient developed multiple abnormal lymph nodes in the left axilla, which were confirmed to be metastasis upon pathology examination. Following radiotherapy, the patient's condition remained stable during the follow-up period.

CONCLUSION

Most MCA lesions typically exhibit clear borders and irregular edges, with some displaying expansive growth and compression of surrounding tissues. Mammography can reveal calcified components in lesions. Ultrasound often reveals an isoechoic or hypoechoic mass with well-defined borders but irregular edges. Magnetic resonance imaging (MRI) can show clear boundaries and uneven enhancement of the lesions, and the timeintensity curve (TIC) of the mass area often shows an inflow enhancement pattern.

摘要

引言

乳腺黏液性囊腺癌(MCA)仍然是一种相对罕见的疾病,迄今为止,尚无关于其影像学表现的系统总结。因此,本报告详细阐述了一名40岁女性黏液性囊腺癌的诊断和治疗过程,特别关注影像学表现。此外,我们对该疾病进行了全面的文献综述,并总结了其关键影像学特征。本手稿为黏液性囊腺癌的准确诊断提供了有价值的见解和方法。

病例介绍

我们报告一名40岁的绝经前女性,她在五年前发现左乳有多个囊肿。在过去两年中,这些肿瘤的大小有所增加。超声检查显示囊肿已增大至27×17mm。穿刺后,囊肿被确认为良性,未进行定期监测。一年后,患者左乳肿块增大,超声检查显示外上象限有可疑混合回声区,提示恶性病变。乳腺钼靶显示病变区域有不定形可疑钙化,呈节段性分布。对比增强磁共振成像显示病变呈非肿块型强化,动态增强成像时间-信号强度曲线(TIC)呈快速上升平台型。术后病理证实为左乳腺浸润性癌伴黏液性囊腺癌。术后四个月,患者左腋窝出现多个异常淋巴结,病理检查证实为转移。放疗后,患者在随访期间病情保持稳定。

结论

大多数MCA病变通常边界清晰但边缘不规则,部分表现为膨胀性生长并压迫周围组织。乳腺钼靶可显示病变中的钙化成分。超声常显示边界清晰但边缘不规则的等回声或低回声肿块。磁共振成像(MRI)可显示病变边界清晰且强化不均匀,肿块区域的时间-强度曲线(TIC)常呈流入性强化模式。

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