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Case Reports
. 2023 Feb 27;18(5):1748-1753.
doi: 10.1016/j.radcr.2023.01.081. eCollection 2023 May.

Masson's tumor of the reconstructed breast

Ian Klonk  1 , Stephen P Povoski  2 , Gary Tozbikian  3 , Jeffrey R Hawley  4
Affiliations
Case Reports

Masson's tumor of the reconstructed breast

Ian Klonk et al. Radiol Case Rep. .

Abstract

Intravascular papillary endothelial hyperplasia (Masson's Tumor) is a rare benign endothelial vascular lesion that can mimic angiosarcoma if not properly recognized. It represents less than 2% of all vascular tumors, but has been seen in the postradiation setting, which also makes differentiating it from angiosarcoma crucial. It is classically characterized as a circumscribed, intravascular mass that is hypoechoic on ultrasound, and T1 isointense and T2 heterogenous on MRI with variable enhancement. Histologically, it demonstrates papillary architecture without significant atypia, and associated vascular thrombus. Although it typically occurs in the soft tissues of the trunk and neck, a very small percentage of cases have been found in the breast. The following case will involve a 64-year-old female with a Masson's tumor involving the capsule of her left breast implant, in the setting of previously treated ductal carcinoma in situ, which was surgically excised and irradiated over 20 years prior.

Keywords: Breast; Intravascular papillary endothelial hyperplasia; Masson's.

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Figures

Fig 1
Fig. 1
Left breast ultrasound shows a peripherally hyperechoic, centrally mixed echogenicity lesion in the 10:00 axis of zone 3, adjacent to the patient's silicone implant. No internal vascularity.
Fig 2
Fig. 2
T1 Precontrast (A), T1 Postcontrast (B), T2 Fast Spin Echo (C), and STIR BLADE (D) MR images demonstrating a T1 isointense, T2 hypointense mass with enhancing medial component along the medial aspect of the left silicone implant. There is also an intracapsular rupture of the silicone implant.
Fig 3
Fig. 3
Ultrasound guided core needle biopsy specimen (H&E 20×) shows predominantly organizing blood clot, with foci showing papillary formations composed of hyaline stalks lined by bland endothelial cells, anastomosing vascular channels. No necrosis, cytologic atypia, or atypical mitotic figures are seen.
Fig 4
Fig. 4
F18 fluorodeoxyglucose Positron Emission Topogragy (A) and Fused Positron Emission Topogragy-CT (B) images demonstrating mild fluorodeoxyglucose avidity with a maximum standard uptake value of 3.8 along the medial aspect of a soft tissue and fluid density in the medial left breast.
Fig 5
Fig. 5
Gross surgical specimen showing an 8-centimeter mass with implant capsule.
Fig 6
Fig. 6
Surgical specimen (H&E 10×) showing chest wall soft tissue, left pectoralis, predominantly organizing blood clot, and focal papillary endothelial hyperplasia.
See this image and copyright information in PMC

References

    1. Masson P. Hemangioendotheliome vegetant intravasculaire. Bull Soc Anat (Paris) 1923;93:517–532.
    1. Clearkin KP, Enzinger FM. Intravascular papillary endothelial hyperplasia. Arch Pathol Lab Med. 1976;100(8):441–444. - PubMed
    1. Barr RJ, Graham JH, Sherwin LA. Intravascular papillary endothelial hyperplasia. A benign lesion mimicking angiosarcoma. Arch Dermatol. 1978;114(5):723–726. - PubMed
    1. Branton PA, Lininger R, Tavassoli FA. Papillary endothelial hyperplasia of the breast: the great impostor for angiosarcoma: a clinicopathologic review of 17 cases. Int J Surg Pathol. 2003;11(2):83–87. doi: 10.1177/106689690301100203. - DOI - PubMed
    1. Lorente-Ramos RM, Azpeitia Armán J, Martínez Izquierdo MA, Pérez Quintanilla A. Papillary endothelial hyperplasia (Masson's tumor) developed in the capsule of the implant in a breast cancer patient treated with mastectomy and radiation therapy. J Clin Ultrasound. 2020;48(4):222–226. doi: 10.1002/jcu.22807. Epub 2019 Dec 20. - DOI - PubMed

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