Imaging manifestations of ductal adenoma of the breast: A case report

Abstract

Tubular adenomas of the breast are rare benign epithelium-derived tumours, and so few cases have been reported. Most often, the tumours are palpable, well-circumscribed masses in women of childbearing age and are commonly diagnosed as fibroadenomas both clinically and radiographically. We describe the case of a premenopausal patient with tubular adenoma of the breast who presented with small nipple discharge and a palpable breast mass. On imaging, tubular adenomas are practically indistinguishable from fibroadenomas and most commonly present as oval, circumscribed masses that are hypoechoic on ultrasound. On magnetic resonance imaging (MRI), tubular adenomas may present as lobulated or oval masses with a hyperintense signal on T2-weighted imaging and inhomogeneous internal enhancement on dynamic contrast-enhanced MRI. Pathologic findings after resection of the mass confirmed the diagnosis of tubular adenoma.

Keywords: breast cancer; magnetic resonance imaging; tubular adenoma; ultrasound.

Figure 1

Ultrasound exam of her left breast revealed oval, parallel, circumscribed, hypoechoic masses (arrows) with internal vascularity (a and b).

Figure 2

MRI of lesions of the left breast (arrows). (a) Lesions with Low signal intensity on T1-weighted images. (b) High signal intensity on T2-weighted images. (c and d) High apparent diffusion coefficient value. (e and f) Dynamic contrast-enhanced imaging with time signal intensity curves for washout pattern.

Figure 3

Tubular adenoma (a and b). Hematoxylin and eosin of core needle biopsy shows a lesion with well-defined borders consisting of small, lined by a basal layer of myoepithelial cells (arrow) and overlying glandular epithelium (arrowhead). There is minimal intertubular fibrous tissue.