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酷似炎性乳腺癌的巨大梗死性泌乳性腺瘤:索马里首例病例报告

Giant Infarcted Lactating Adenoma Mimicking Inflammatory Breast Carcinoma: A First Case Report from Somalia.

作者信息

Abdullahi Ismail Mohamud, Ibrahim Ismail Gedi

机构信息

Mogadishu Somalia Türkiye Recep Tayyip Erdoğan Research and Training Hospital, Department of Pathology, Mogadishu, Somalia.

Mogadishu Somalia Türkiye Recep Tayyip Erdoğan Research and Training Hospital, Department of Radiology, Mogadishu, Somalia.

出版信息

Int Med Case Rep J. 2025 Jul 26;18:931-936. doi: 10.2147/IMCRJ.S528825. eCollection 2025.

Abstract

A lactating adenoma is a rare and benign breast tumor that usually occurs during pregnancy or lactation period for women. These adenomas are typically small, <3 centimeters, well circumscribed, mobile, and lobulated masses, and are most commonly witnessed in primiparous women (those having their first child) between the ages of 20 and 40 years during the third trimester of their pregnancies due to hormonal changes. In this case report, we describe an unusual variant of lactating adenoma that is characterized by the ischemic infarction of breast tissue and its giant dimensions, surpassing 16 centimeters. The case in question had poorly defined margins in addition to chronic mastitis, which can make differentiating from standard lactating adenoma presentations quite difficult clinically. Infarction associated with chronic mastitis serves to complicate the distinction, and tends to mimic inflammatory breast carcinoma. This case report emphasizes how these rare and unusual presentations of lactating adenomas can mimic a highly aggressive malignancy, leading to diagnostic confusion and potentially unnecessary interventions. Inflammatory breast carcinoma is a rapidly progressive malignancy requiring aggressive oncological management, unlike infarcted lactating adenomas, which are benign and can be effectively treated with surgical excision alone. This case adds an important dimension to the medical literature, particularly given its context of occurrence in Somalia, where resources and access to advanced diagnostic tools are limited. By detailing this unique instance, the study not only contributes to the understanding of breast pathology but also emphasizes the necessity for keen clinical acumen in achieving appropriate therapeutic interventions in diverse health-care settings.

摘要

泌乳性腺瘤是一种罕见的良性乳腺肿瘤,通常发生于女性的孕期或哺乳期。这些腺瘤通常较小,<3厘米,边界清晰,可活动,呈分叶状肿块,最常见于初产妇(生育第一胎的女性),年龄在20至40岁之间,于妊娠晚期因激素变化而出现。在本病例报告中,我们描述了一种不寻常的泌乳性腺瘤变体,其特征为乳腺组织缺血性梗死及其巨大尺寸,超过16厘米。该病例除慢性乳腺炎外,边界不清,这在临床上很难与标准的泌乳性腺瘤表现相鉴别。与慢性乳腺炎相关的梗死使鉴别变得复杂,并往往酷似炎性乳腺癌。本病例报告强调了泌乳性腺瘤这些罕见且不寻常的表现如何能酷似高度侵袭性的恶性肿瘤,导致诊断混淆并可能引发不必要的干预。炎性乳腺癌是一种快速进展的恶性肿瘤,需要积极的肿瘤学管理,而梗死性泌乳性腺瘤是良性的,仅通过手术切除即可有效治疗。该病例为医学文献增添了重要内容,特别是考虑到其发生在索马里的背景,那里资源有限且难以获得先进的诊断工具。通过详细描述这一独特病例,该研究不仅有助于对乳腺病理学的理解,还强调了在不同医疗环境中实现适当治疗干预时敏锐临床洞察力的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c018/12309573/5d7f50f05703/IMCRJ-18-931-g0001.jpg

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