September 2018

Breast lesion in two patients

Clinical Info

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 and also part of the cyst wall.
The solid part of the mass is vascularized and also part of the cyst wall.
Another image of the vascularized solid part.The lesion proved to be a squamus cell carcinoma. These carcinomas are rather unusual. No other primary squamus cell carcinoma was found so this proved to be a primary poorly differentiated squamus cell carcino
Another image of the vascularized solid part.The lesion proved to be a squamus cell carcinoma. These carcinomas are rather unusual. No other primary squamus cell carcinoma was found so this proved to be a primary poorly differentiated squamus cell carcino
This is an image from another patient with a vascularized intracystic mass. But this lesion proved to be a benign papilloma
This is an image from another patient with a vascularized intracystic mass. But this lesion 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.
The same mass with compression. The mass can be deformed.
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. Although the lesion looks malignant it has very little flow. It proved to be benign. The lesion was a sclerosing adenosis. These lesions are often indistinguishable from malignant lesions, as is the case with this patient
Another image with color doppler. Although the lesion looks malignant it has very little flow. It proved to be benign. The lesion was a sclerosing adenosis. These lesions are often indistinguishable from malignant lesions, as is the case with this patient
This is an image of another patient with sclerosing adenosis
This is 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

  • Hitachi Ultrasound System