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September 2018

Breast lesion in two patients
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Clinical information

Two middle age female patients examined for SONOZORG a primary care ultrasound facility. Both patients have a lump in the breast.

Which of the lesions is malignant?
A) The right patient
B) The left patient
C) Both patients
D) None of the patients

Ultrasound Images & Clips

Breast lesion in two patients

Breast lesion in two patients Which of the lesions is malignant? A The right patient B The left patient C Both patients D None of the patients
Breast lesion in two patients Which of the lesions is malignant? A The right patient B The left patient C Both patients D None of the patients
The first patient had a large mainly cystic mass with solid parts
The first patient had a large mainly cystic mass with solid parts
Another image of the same lesion
Another image of the same lesion
The solid part of the mass is vascularized
The solid part of the mass is vascularized
Another image of the vascularized solid part
Another image of the vascularized solid part
This is an image from another patient with a vascularized intracystic mass that proved to be a benign papilloma
This is an image from another patient with a vascularized intracystic mass that proved to be a benign papilloma
This is the mass of the second patient. The mass has very irregular margins and spiculations
This is the mass of the second patient. The mass has very irregular margins and spiculations
Another image of the mass without compression
Another image of the mass without compression
The same mass with compression. The mass can be deformed slightly.
The same mass with compression. The mass can be deformed slightly.
The mass doesn't show any flow with color doppler
The mass doesn't show any flow with color doppler
Another image with color doppler
Another image with color doppler
This an image of another patient with sclerosing adenosis
This an image of another patient with sclerosing adenosis
This is another patient with sclerosing adenosis
This is another patient with sclerosing adenosis
This is an other patient with a benign lesion (chronic inflammation) looking suspicious
This is an other patient with a benign lesion (chronic inflammation) looking suspicious

Conclusion

Both lesions were classified as BIRADS 4(C) The first lesion could have been an intracystic papilloma, but also very well be a partly cystic malignant tumor. The mass was removed and proved to be a primary poorly differentiated squamus cell carcinoma. The lesion of the second patient proved to be benign sclerosing adenosis. It is known that sclerosing adenosis can mimic malignant lesions.
Lesions that can be malignant should always be classified as BIRADS 4 and biopsied or surgically removed

Details

  • Sex: Female

Created with

  • Fujifilm Ultrasound System
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photo Taco Geertsma
Author

Dr. Taco Geertsma

Retired Radiologist, Gelderse Vallei Hospital

Dr. Taco Geertsma is the founder of UltrasoundCases.info and a retired radiologist and has worked in the Gelderse Vallei hospital from January 1, 1983. till July 1, 2014. He was the head of the ultrasound department for many years.

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