October 2010

Hypoechoic mass in the left breast

Clinical Info

Palpable mass in the left breast in a severely physically handicapped patient with bluish discoloration of the skin

Ultrasound Images & Clips

Hypoechoic mass in the left breast

Hypoechoic mass in the left breast with partly anechoic areas.
Hypoechoic mass in the left breast with partly anechoic areas.
Transverse image of the same mass with anechoic areas
Transverse image of the same mass with anechoic areas
Color doppler reveals only one small vessel
Color doppler reveals only one small vessel
A hematoma was suspected and a puncture was performed. The mass proved to be a hematoma and nearly all the blood was aspirated. The image shows the needle in the hematoma after aspiration. After the puncture there was no detectable mass or abnormal flow.
A hematoma was suspected and a puncture was performed. The mass proved to be a hematoma and nearly all the blood was aspirated. The image shows the needle in the hematoma after aspiration. After the puncture there was no detectable mass or abnormal flow.
A half year later the patient presented again with a lump in the same breast at the same site. Again a hematoma was found without any flow in the hematoma. Image shows no flow with color doppler
A half year later the patient presented again with a lump in the same breast at the same site. Again a hematoma was found without any flow in the hematoma. Image shows no flow with color doppler
This time however a solid looking mass was identified next to the hematoma
This time however a solid looking mass was identified next to the hematoma
Transverse image of the mass next to the hematoma
Transverse image of the mass next to the hematoma
The mass was highly vascularized
The mass was highly vascularized
The mass has multiple vessel poles. At this time a tumor  causing the recurrent hematoma was presumed and an ultrasound guided biopsy was performed. The histological diagnosis was suspicious for a micropapillary carcinoma
The mass has multiple vessel poles. At this time a tumor causing the recurrent hematoma was presumed and an ultrasound guided biopsy was performed. The histological diagnosis was suspicious for a micropapillary carcinoma

Conclusion

The patient was operated. The final diagnosis was a recurrent hematoma caused by a malignant micropapillary breast cancer.
In case of a hematoma without a history of trauma, one should be aware of a possible tumor causing the hemorrhage. Although we searched for a mass the first time the patient presented with a hematoma, we were not able to detect one. Her physical condition led us to the wrong presumption that the trauma had not been noticed


Details

  • Sex: Female
  • Age: 51

Created with

  • Hitachi Ultrasound System