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Case Reports
. 2009 Oct;5(4):e27.
doi: 10.2349/biij.5.4.e27. Epub 2009 Oct 1.

Medullary carcinoma of the breast: Role of contrast-enhanced MRI in the diagnosis of multiple breast lesions

Sn Abdul Rashid  1 , K Rahmat, Kj Jayaprasagam, K Alli, F Moosa
Affiliations
Case Reports

Medullary carcinoma of the breast: Role of contrast-enhanced MRI in the diagnosis of multiple breast lesions

Sn Abdul Rashid et al. Biomed Imaging Interv J. 2009 Oct.

Abstract

Medullary carcinoma is a rare breast carcinoma with a syncytial growth pattern and high-grade cytology. It can be difficult to diagnose and may be missed on conventional imaging as the findings may overlap with benign lesions i.e. fibroadenomas. The authors report a case of a 25-year-old female who presented with multifocal breast lumps diagnosed with medullary carcinoma and fibroadenomas. Imaging and pathological correlation with contrast-enhanced MRI are presented in the diagnosis of these lesions.

Keywords: Fibroadenoma; medullary carcinoma breast; ultrasonography.

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Figures

Figure 1
Figure 1
Ultrasound examination of the right breast showing a well circumscribed hypoechoic mass (white arrow) with internal echogenicity and acoustic enhancement with lobulated margins.
Figure 2
Figure 2
Mammograms showed dense breast parenchymal pattern limiting the sensitivity of the examination. No suspicious masses, architectural distortion or microcalcifications were present.
Figure 3
Figure 3
MRI study of the breasts showing the medullary carcinoma in the right breast adjacent to the pectoralis muscle (long white arrow) appearing (a) isointense on T2W STIR axial (TR: 5450, TE: 60), (b) isointense on T1W fat sat axial sequence (TR: 11.2, TE: 5), (c) demonstrated homogenous enhancement during the early dynamic post-gadolinium sequence at 1 minute, and (d) delayed peripheral enhancement during the dynamic post-gadolinium at 6 minutes, suggestive of a malignant lesion. Note the smaller three enhancing fibroadenomas in the left breast (short white arrows) in (c) and (d), which demonstrated gradual homogenous enhancement throughout the dynamic phases.
Figure 4
Figure 4
Dynamic contrast-enhanced time intensity curves of (a) the right breast mass with early wash-in and early wash-out pattern, (b) the benign left breast lesions with gradual enhancement pattern throughout the dynamic phases.
Figure 5
Figure 5
Histopathology slide showing lymphocytic infiltration with solid sheets of large anaplastic cells with syncytial growth.
See this image and copyright information in PMC

References

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