Breast hemangioma with difficulty in preoperative diagnosis: a case report

Abstract

We report a rare case of breast hemangioma found in a 70-year-old Japanese female. Before seeking medical attention, the patient noticed a hard mass in her right breast but denied associated symptoms. A mammography revealed a well-circumscribed, highly dense, lobular nodule located in the middle inter portion of the right breast. To verify this finding, we used ultrasonography which revealed an irregular, iso-echoic nodule measuring 10 mm in the same portion. Based on these findings, we suspected a malignancy and performed a core needle biopsy. Unexpectedly, a histological examination of the biopsy displayed normal vasculature, adipose, and mammary tissues. In order to make an accurate diagnosis, the mass was surgically excised under general anesthesia and sent to pathology. Pathological findings of the mass were positive for breast hemangioma, and the patient has had no recurrence of the disease for the past 24 months.

Figure 1

A mammography revealed a circumscribed, high-density lobular nodule. a. The nodule measured 1 cm in diameter and was located in the middle inter portion of her right breast. b. An ultrasonography (US) revealed a heterogeneous, iso-echoic mass with irregular margins measuring 10 × 12 mm in diameter. No accompanying posterior acoustical shadowing was observed.

Figure 2

Enhanced computed tomography and magnetic resonance imaging findings. a. Enhanced computed tomography showed a well-enhanced nodule in both the early and late phase. b. Dynamic T-1 weighted image revealed a highly intense nodule in the right breast (A). A subtraction image showed a hyper-intense nodule in early and late phases (B, C).

Figure 3

Macroscopic view of the surgical specimen.

Figure 4

Hematoxylin and eosin-stained section demonstrated that the tumor consisted of both dilated and congested vessels filled with numerous red blood cells.