Asunto(s)
Neoplasias Fibroepiteliales , Neoplasias Cutáneas , Humanos , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patología , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/patología , Neoplasias Fibroepiteliales/cirugía , Femenino , Masculino , Persona de Mediana EdadRESUMEN
Cutaneous basal cell carcinoma in situ is a recently proposed subtype of this skin cancer. It is characterized by either restriction of the tumor cells within the epidermis or the presence of tumor cells contiguous with the overlying epidermis that extend into the underlying dermis, or both. Importantly, cancer invasion-demonstrated by non-contiguous aggregates of basaloid tumor cells in the dermis-is not a feature of in situ basal cell carcinoma of the skin. A 63-year-old woman with cutaneous basal cell carcinoma in situ-superficial type that presented as an erythematous scaly plaque on her abdomen and a 61-year-old man with a cutaneous basal cell carcinoma in situ-fibroepithelioma type that presented as a flesh-colored smooth exophytic nodule on his back are reported. The characteristics of in situ basal cell carcinoma of the skin in these individuals are summarized. In conclusion, similar to other cutaneous malignant neoplasms-such as squamous cell carcinoma, malignant melanoma, and Merkel cell carcinoma-basal cell carcinoma of the skin can also present as an in situ cancer.
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Carcinoma Basocelular , Neoplasias Cutáneas , Humanos , Neoplasias Cutáneas/patología , Carcinoma Basocelular/patología , Persona de Mediana Edad , Femenino , Masculino , Carcinoma in Situ/patología , Neoplasias Fibroepiteliales/patología , Neoplasias Fibroepiteliales/diagnósticoRESUMEN
Bronchial fibroepithelial polyps are exceedingly rare with few cases have been reported. They can manifest with a wide array of symptoms; ranging from being totally asymptomatic, cough, refractory dyspnea, and hemoptysis. In our case, our patient's condition was diagnosed and was managed as asthma. It is one of the rare benign conditions to be encountered, shares similar morphology with other tumors such as angiomyofibroblastoma, aggressive angiomyxoma, and cellular angiofibroma. These lesions have a slow growth pattern which may end up with obstruction. According to the tumor size and symptoms caused by it, treatment varies from observation to complete resection. This case describes an incidental finding of fibroepithelial polyp in the main bronchus for a patient with long-term refractory cough for 5 years, was misdiagnosed to have asthma. Diagnosis typically involves imaging and bronchoscopy, followed by appropriate therapeutic measures and careful monitoring to assess the prognosis.
Asunto(s)
Asma , Neoplasias de los Bronquios , Broncoscopía , Errores Diagnósticos , Pólipos , Humanos , Asma/diagnóstico , Pólipos/patología , Pólipos/diagnóstico , Neoplasias de los Bronquios/diagnóstico , Neoplasias de los Bronquios/patología , Neoplasias de los Bronquios/diagnóstico por imagen , Neoplasias de los Bronquios/cirugía , Masculino , Tomografía Computarizada por Rayos X , Persona de Mediana Edad , Tos/etiología , Femenino , Neoplasias Fibroepiteliales/patología , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/cirugía , Bronquios/patologíaRESUMEN
A 75-year-old Black man presented for evaluation of a skin lesion on his right shoulder. The lesion had been present for 3 months and was bleeding. A physical exam demonstrated a 2.7 cm exophytic, crusted, blue-to-purple plaque. A shave biopsy was performed, and histopathological examination revealed anastomosing strands of basaloid cells in the dermis, leading to a diagnosis of fibroepithelioma of pinkus (FeP). FeP is a rare variant of basal cell carcinoma. It typically presents as a solitary, pink, pedunculated papule on the lower back, but the presentation can vary. This case contributes to the scarce literature on the occurrence of FeP in skin of color populations. Here, we raise the possibility that FeP may present differently in skin of color patients compared to white patients. Greater clinician awareness can foster improved identification, management, and understanding of FeP in diverse populations.
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Hombro , Neoplasias Cutáneas , Anciano , Humanos , Masculino , Biopsia , Carcinoma Basocelular/patología , Carcinoma Basocelular/diagnóstico , Neoplasias Fibroepiteliales/patología , Neoplasias Fibroepiteliales/diagnóstico , Hombro/patología , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , Negro o AfroamericanoRESUMEN
We report the case of a young man who has never had any sexual contact presenting with a large scrotal lump with secondary bacterial infection. He reported no prior warts - genital or cutaneous. On examination, he had a large pink cauliform mass on the scrotum with four smaller but similar satellite lesions. Appearances were thought to be consistent with giant condyloma of Buschke and Lowenstein. Once superinfection was treated with oral antibiotics, he had a trial of imiquimod without success and was then referred to urology. After surgical excision, pathology concluded it was an inflamed fibroepithelial polyp with no malignant changes. To our knowledge, this is the first case report of a giant scrotal fibroepithelial polyp with characteristic gross warty features in an adult.
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Condiloma Acuminado , Pólipos , Escroto , Humanos , Masculino , Escroto/patología , Pólipos/diagnóstico , Pólipos/patología , Pólipos/cirugía , Condiloma Acuminado/diagnóstico , Condiloma Acuminado/patología , Condiloma Acuminado/cirugía , Diagnóstico Diferencial , Adulto , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/patología , Neoplasias Fibroepiteliales/cirugía , Resultado del TratamientoRESUMEN
Fibroadenomas are the most common breast lesion in women of reproductive age. During pregnancy and lactation, fibroadenomas can undergo rapid growth in response to hormonal stimulus. These changes may prompt further investigation and/or intervention due to the risk of an underlying phyllodes tumour. We present a case of a female patient who underwent surgical excision of a giant fibroepithelial lesion at 4 months post partum while continuing to breastfeed. The lesion was successfully excised while maintaining lactation. A postoperative milk fistula resolved with non-operative management. There is limited literature on the surgical management of breast lesions in lactating women. This case illuminates the surgical management of breast lesions in an often well informed group of patients who may choose to have surgery while lactating in spite of the increased risk of complications. This case also highlights the need for a holistic approach to maintain the overall health of mother and child.
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Neoplasias de la Mama , Fibroadenoma , Fibroma , Neoplasias Fibroepiteliales , Tumor Filoide , Embarazo , Niño , Femenino , Humanos , Fibroadenoma/cirugía , Fibroadenoma/patología , Lactancia , Neoplasias de la Mama/cirugía , Neoplasias de la Mama/patología , Neoplasias Fibroepiteliales/patología , Mama/patología , Tumor Filoide/patología , Fibroma/patologíaRESUMEN
Vulval fibroepithelial polyps (FEPs) are a rare type of vulval fibroblastic tumour commonly found in premenopausal women. It is important to obtain an accurate pathological diagnosis because, despite being benign, the condition shares some characteristics with malignant vulva lesions in its differential diagnosis. We present a case of young woman in her 20s with a giant FEP. After surgical excision, the patient did not manifest any signs of recurrence after 1-year follow-up. Our review focuses on the distinguishing characteristics of these rare neoplasms as we explore their differential diagnosis.
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Neoplasias Fibroepiteliales , Neoplasias de Tejido Fibroso , Pólipos , Neoplasias de la Vulva , Femenino , Humanos , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/cirugía , Neoplasias Fibroepiteliales/patología , Neoplasias de Tejido Fibroso/patología , Pólipos/diagnóstico , Pólipos/cirugía , Pólipos/patología , Vulva/patología , Neoplasias de la Vulva/diagnóstico , Neoplasias de la Vulva/cirugía , Neoplasias de la Vulva/patología , AdultoRESUMEN
Onychomatricoma is a rare, fibroepithelial tumor of the nail. Although it is benign, unnecessary and excessive treatment, such as extensive or total removal of the nail matrix, has been reported in the past. Recently, it was speculated that onychomatricoma is derived from onychomatricodermis, the dermal stroma of the nail matrix. Excision of the stromal rather than the epithelial component of the tumor is important. However, since the boundary between the normal and diseased stroma is usually unclear, minimal excision at the base of the tumor projection should be sufficient. We report a case of onychomatricoma and suggest a method of surgical treatment that would minimize postoperative deformity of the nail plate.
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Procedimientos Quirúrgicos Mínimamente Invasivos , Enfermedades de la Uña , Neoplasias Cutáneas , Humanos , Masculino , Procedimientos Quirúrgicos Mínimamente Invasivos/métodos , Enfermedades de la Uña/cirugía , Enfermedades de la Uña/patología , Enfermedades de la Uña/diagnóstico , Uñas/cirugía , Uñas/patología , Neoplasias Fibroepiteliales/cirugía , Neoplasias Fibroepiteliales/patología , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Cutáneas/cirugía , Neoplasias Cutáneas/patología , Neoplasias Cutáneas/diagnóstico , AdultoRESUMEN
BACKGROUND: Breast fibroadenomas and phyllodes tumors are both fibroepithelial tumors with comparable histological characteristics. However, rapid and precise differential diagnosis is a tough point in clinical pathology. Given the tendency of phyllodes tumors to recur, the difficulty in differential diagnosis with fibroadenomas leads to the difficulty in optimal management for these patients. METHOD: In this study, we used Raman spectroscopy to differentiate phyllodes tumors from breast fibroadenomas based on the biochemical and metabolic composition and develop a classification model. The model was validated by 5-fold cross-validation in the training set and tested in an independent test set. The potential metabolic differences between the two types of tumors observed in Raman spectroscopy were confirmed by targeted metabolomic analysis using liquid chromatography-tandem mass spectrometry (LC-MS/MS). RESULTS: A total of 204 patients with formalin-fixed paraffin-embedded (FFPE) tissue samples, including 100 fibroadenomas and 104 phyllodes tumors were recruited from April 2014 to August 2021. All patients were randomly divided into the training cohort (n = 153) and the test cohort (n = 51). The Raman classification model could differentiate phyllodes tumor versus fibroadenoma with cross-validation accuracy, sensitivity, precision, and area under curve (AUC) of 85.58 % ± 1.77 %, 83.82 % ± 1.01 %, 87.65 % ± 4.22 %, and 93.18 % ± 1.98 %, respectively. When tested in the independent test set, it performed well with the test accuracy, sensitivity, specificity, and AUC of 83.50 %, 86.54 %, 80.39 %, and 90.71 %. Furthermore, the AUC was significantly higher for the Raman model than that for ultrasound (P = 0.0017) and frozen section diagnosis (P < 0.0001). When it came to much more difficult diagnosis between fibroadenoma and benign or small-size phyllodes tumor for pathological examination, the Raman model was capable of differentiating with AUC up to 97.45 % and 95.61 %, respectively. On the other hand, targeted metabolomic analysis, based on fresh-frozen tissue samples, confirmed the differential metabolites (including thymine, dihydrothymine, trans-4-hydroxy-l-proline, etc.) identified from Raman spectra between phyllodes tumor and fibroadenoma. SIGNIFICANCE AND NOVELTY: In this study, we obtained the molecular information map of breast phyllodes tumors provided by Raman spectroscopy for the first time. We identified a novel Raman fingerprint signature with the potential to precisely characterize and distinguish phyllodes tumors from fibroadenoma as a quick and accurate diagnostic tool. Raman spectroscopy is expected to further guide the precise diagnosis and optimal treatment of breast fibroepithelial tumors in the future.
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Neoplasias de la Mama , Fibroadenoma , Neoplasias Fibroepiteliales , Tumor Filoide , Humanos , Femenino , Tumor Filoide/diagnóstico , Tumor Filoide/metabolismo , Tumor Filoide/patología , Fibroadenoma/diagnóstico , Fibroadenoma/metabolismo , Fibroadenoma/patología , Espectrometría Raman , Cromatografía Liquida , Espectrometría de Masas en Tándem , Neoplasias de la Mama/patologíaRESUMEN
BACKGROUND: Onychomatricoma is a nail neoplasm that usually presents as longitudinal nail plate thickening, involving either the partial or whole nail. Histopathologically, it is characterized by deep invaginations of the proliferating nail matrix and proliferation of CD34+ and CD10+ spindle cells with collagenous to myxoid stroma. Onychomatricoma has been considered a fibroepithelial neoplasm. Recently, RB1 loss has been verified using array comparative genomic hybridization. METHODS: This study investigated the RB1 status in onychomatricoma with morphological methods. RESULTS: Six patients with onychomatricoma were included in the study. RB1 status was assessed using immunohistochemical staining and fluorescence in situ hybridization. Immunohistochemical staining showed that all six cases experienced RB1 loss in the mesenchymal component of onychomatricoma but not in the proliferated nail matrix. Fluorescence in situ hybridization in five cases showed a monoallelic deletion of the RB1 locus in the mesenchymal component but not in the proliferated nail matrix. CONCLUSIONS: RB1 loss was observed only in the mesenchymal component of onychomatricoma. Our findings suggest that the proliferated nail matrix in onychomatricoma represents reactive hyperplasia of various degrees secondary to neoplastic mesenchymal proliferation. This indicates that onychomatricoma should be recognized as an RB1-deleted soft tissue neoplasm rather than a fibroepithelial neoplasm.
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Enfermedades de la Uña , Neoplasias Fibroepiteliales , Neoplasias Cutáneas , Humanos , Neoplasias Cutáneas/genética , Hibridación Fluorescente in Situ , Hibridación Genómica Comparativa , Enfermedades de la Uña/genética , Ubiquitina-Proteína Ligasas , Proteínas de Unión a RetinoblastomaRESUMEN
Fibroma mole, ou pólipo fibroepitelial, é uma lesão de proporções geralmente reduzidas, de cor hiperpigmentada ou igual à da pele, localizando-se frequentemente na face, pescoço, tronco e regiões intertriginosas. É um tumor classificado como benigno e pode acometer tanto homens quanto mulheres em idade reprodutiva e depois da quarta década de vida. Ocorre principalmente em obesos, diabéticos e durante a gestação. Com menor frequência, podem alcançar dimensões que excedem 5 cm. Seu crescimento pode ser lento ou rápido e comumente são assintomáticos, mas podem promover sangramentos por conta de ulcerações decorrentes de traumas repetidos. Apresentamos neste relato um fibroma mole, gigante, de localização vulvar, com 11 cm de comprimento, 11 cm de largura e 5 cm de espessura, pesando 500 g.
Giant soft vulvar fibroma is a fibroepithelial polyp lesion with generally reduced proportions, with a hyperpigmented color or similar to that of the skin, frequently located on the face, neck, trunk and intertriginous regions. It is a tumor classified as benign, can affect both men and women, of reproductive age and after the fourth decade, mainly obese, diabetic and during pregnancy. However, less frequently, they can reach dimensions that exceed 5 cm, may have a slow or accelerated evolution. They are commonly asymptomatic, but bleeding may be present due to ulcerations resulting from repeated trauma. In the current study, we describe a giant soft fibroma with a vulvar location measuring 11 cm in length, 11 cm in width, 5 cm in thickness and weighing 500 grams.
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Humanos , Femenino , Adulto , Fibroma/cirugía , Fibroma/etiología , Procedimientos Quirúrgicos Ginecológicos , Vulva/patología , Enfermedades de la Vulva/complicaciones , Neoplasias de la Vulva , Heridas y Lesiones/complicaciones , Informes de Casos , Células del Estroma/patología , Neoplasias Fibroepiteliales/rehabilitaciónRESUMEN
AIMS: Juvenile fibroadenomas (JFA) are biphasic fibroepithelial lesions (FEL) usually occurring in adolescent female patients. Giant (G) JFA, like other FEL, may exhibit prominent pseudoangiomatous stromal hyperplasia (PASH)-like change. We sought to determine clinicopathological and molecular characteristics of GJFA with and without PASH. METHODS AND RESULTS: Archives were searched for cases of GJFA (1985-2020). All were stained for androgen receptor (AR), beta-catenin, CD34 and progesterone receptor (PR). Cases were sequenced using a custom 16-gene panel - MED12 (exons 1 and 2), TERT promoter (-124C>T and -146Ctable>T), SETD2, KMT2D, RARA (exons 5-9), FLNA, NF1, PIK3CA (exons 10, 11 and 21), EGFR, RB1, BCOR, TP53, PTEN, ERBB4, IGF1R and MAP3K1. Twenty-seven GJFA from 21 female patients aged 10.1-25.2 years were identified. Size ranged from 5.2 to 21 cm. Two patients had multiple, bilateral and later recurrent GJFA. Thirteen (48%) cases showed prominent PASH-like stroma. All were positive for stromal CD34, negative for AR and beta-catenin and one case showed focal PR expression. Sequencing showed MAP3K1 and SETD2 mutations in 17 samples, with KMT2D, TP53 and BCOR aberrations in 10 (45%), 10 (45%) and seven (32%) cases, respectively. Tumours with a PASH-like pattern had higher prevalence of SETD2 (P = 0.004) and TP53 (P = 0.029) mutations, while those without PASH had more RB1 mutations (P = 0.043). MED12 mutation was identified in one case. TERT promoter mutation was observed in four (18%), including two recurrences. CONCLUSIONS: Gene mutations along more advanced phases of the proposed FEL pathogenetic pathway in GJFA are unusual, and suggest a mechanism for more aggressive growth in these tumours.
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Enfermedades de la Mama , Neoplasias de la Mama , Fibroadenoma , Fibroma , Neoplasias Fibroepiteliales , Adolescente , Humanos , Femenino , beta Catenina , Fibroadenoma/genética , Fibroadenoma/patología , Enfermedades de la Mama/patología , Neoplasias de la Mama/patología , Hiperplasia/genéticaRESUMEN
Phyllodes tumours of the breast are uncommon fibroepithelial neoplasms that pose recurrent classification challenges, in large part due to the multiple histological parameters of stromal hypercellularity and atypia, stromal mitotic count, stromal overgrowth and tumour borders, that are used for grading. While the World Health Organization (WHO) Classification of Breast Tumours provides recommendations on diagnostic features, defining criteria are not always applied in routine practice. Lack of concordance among pathologists in typing and grading further underscores the classification difficulties, especially in the borderline category. Although there has been significant molecular information on phyllodes tumours in recent years which has been diagnostically helpful, it has not been translated into daily clinical practice. In order to refine the classification of phyllodes tumours into one that is simple yet comprehensive, reproducible and prognostically precise, a multipronged approach is needed that leverages on global contributions of the International Fibroepithelial Consortium, support by the International Collaboration on Cancer Classification and Research (IC3 R) in amalgamating evidence translation, and guidance from the International Collaboration on Cancer Reporting (ICCR) for standardised reporting. It is hoped that the evidence generated can be used towards refining the classification of phyllodes tumours for the future.
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Neoplasias de la Mama , Fibroadenoma , Neoplasias Fibroepiteliales , Tumor Filoide , Humanos , Femenino , Tumor Filoide/diagnóstico , Tumor Filoide/patología , Fibroadenoma/patología , Mama/patología , Neoplasias de la Mama/diagnósticoRESUMEN
Fibroepithelioma of Pinkus (FeP) is a rare skin tumor with a clinical presentation similar to benign neoplasms such as acrochordons and seborrheic keratoses. Our study analyzed if there is an association between FeP and internal tumors, specifically gastrointestinal tract tumors. We retrospectively reviewed the medical records of patients with FeP for other tumors throughout their lives until 2020. Although the quality of documentation for each patient may have differed, this study suggests that the presence of FeP does not indicate the presence of gastrointestinal tract tumors, and there is no need for altered cancer screening recommendations for those with FeP.
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Neoplasias Encefálicas , Carcinoma Basocelular , Neoplasias Fibroepiteliales , Neoplasias Cutáneas , Humanos , Estudios Retrospectivos , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/patología , Carcinoma Basocelular/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/patologíaRESUMEN
Objective: To investigate the pathological features and the clinicopathological significance of TERT detection in those tumors that were difficult to diagnosis. Methods: A total of 93 cases of fibroepithelial tumors without definite diagnosis were collected from the Affiliated Hospital of Qigndao University between 2013 and 2021. The clinical details such as patients' age and tumor size were collected. All slides were re-reviewed and the pathologic parameters, including stromal cellularity, stromal cell atypia, stromal cell mitoses, and stromal overgrowth were re-interpreted. Sanger sequencing was used to detect TERT promoter status, and immunohistochemistry was performed to detect TERT protein expression. The relationship between TERT promoter mutation as well as protein expression levels and the clinicopathological parameters were also analyzed. Results: The patients' ages ranged from 30 to 71 years (mean of 46 years); the tumor size ranged from 1.2 to 8.0 cm (mean 3.8 cm). These tumors showed the following morphologic features: leafy structures in the background of fibroadenoma, or moderately to severely abundant stromal cells. The interpretations of tumor border status were ambiguous in some cases. The incidence of TERT promoter mutation was high in patients of age≥50 years, tumor size≥4 cm, and stromal overgrowth at ×4 or ×10 objective, and these clinicopathologic features were in favor of diagnosis of phyllodes tumors. TERT protein expression levels was not associated with the above clinicopathologic parameters and its promoter mutation status. Conclusions: The diagnostic difficulty for the breast fibroepithelial tumors is due to the difficulty in recognition of the leafy structures or in those cases with abundant stromal cells. A comprehensive evaluation combined with morphologic characteristics and molecular parameters such as TERT promoter may be helpful for the correct diagnosis and better evaluating recurrence risk.
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Neoplasias de la Mama , Fibroadenoma , Neoplasias Fibroepiteliales , Tumor Filoide , Telomerasa , Humanos , Adulto , Persona de Mediana Edad , Anciano , Femenino , Neoplasias Fibroepiteliales/patología , Tumor Filoide/diagnóstico , Tumor Filoide/genética , Células del Estroma , Fibroadenoma/diagnóstico , Fibroadenoma/genética , Fibroadenoma/patología , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Mutación , Telomerasa/genéticaRESUMEN
BACKGROUND: Malignant phyllodes tumour (MPT) is a rare breast malignancy with epithelial and mesenchymal features. Currently, there are no appropriate research models or effective targeted therapeutic approaches for MPT. METHODS: We collected fresh frozen tissues from nine patients with MPT and performed whole-exome and RNA sequencing. Additionally, we established patient-derived xenograft (PDX) models from patients with MPT and tested the efficacy of targeting dysregulated pathways in MPT using the PDX model from one MPT. RESULTS: MPT has unique molecular characteristics when compared to breast cancers of epithelial origin and can be classified into two groups. The PDX model derived from one patient with MPT showed that the mouse epithelial component increased during tumour growth. Moreover, targeted inhibition of platelet-derived growth factor receptor (PDGFR) and phosphoinositide 3-kinase (PI3K)/mammalian target of rapamycin (mTOR) by imatinib mesylate and PKI-587 showed in vivo tumour suppression effects. CONCLUSIONS: This study revealed the molecular profiles of MPT that can lead to molecular classification and potential targeted therapy, and suggested that the MPT PDX model can be a useful tool for studying the pathogenesis of fibroepithelial neoplasms and for preclinical drug screening to find new therapeutic strategies for MPT.
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Neoplasias de la Mama , Neoplasias Fibroepiteliales , Tumor Filoide , Humanos , Animales , Ratones , Femenino , Fosfatidilinositol 3-Quinasas , Línea Celular Tumoral , Mesilato de Imatinib , Neoplasias de la Mama/patología , Tumor Filoide/patología , Ensayos Antitumor por Modelo de Xenoinjerto , MamíferosRESUMEN
CONTEXT.: This review article derives from the breast pathology lecture at the Eighth Princeton Integrated Pathology Symposium (PIPS VIII). OBJECTIVE.: To provide a literature review and update on fibroepithelial lesions of the breast with molecular findings and findings regarding the pediatric population. DATA SOURCES.: The sources include extensive literature review, personal research, and experience. CONCLUSIONS.: Given significant differences in prognosis and management of fibroepithelial lesions, we aim to provide readers with pertinent definitions, pathomorphology, molecular findings, and management for each diagnosis, with insights on the pediatric population.
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Neoplasias de la Mama , Fibroadenoma , Neoplasias Fibroepiteliales , Tumor Filoide , Niño , Humanos , Femenino , Tumor Filoide/patología , Fibroadenoma/diagnóstico , Fibroadenoma/patología , Diagnóstico Diferencial , Mama/patología , Neoplasias de la Mama/diagnóstico , Neoplasias de la Mama/patología , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/patologíaAsunto(s)
Neoplasias Fibroepiteliales , Pólipos , Neoplasias de la Vulva , Femenino , Humanos , Neoplasias Fibroepiteliales/diagnóstico , Neoplasias Fibroepiteliales/cirugía , Neoplasias Fibroepiteliales/patología , Pólipos/diagnóstico por imagen , Pólipos/cirugía , Pólipos/patología , Vulva/cirugía , Vulva/patología , Neoplasias de la Vulva/cirugía , Neoplasias de la Vulva/patología , AdolescenteRESUMEN
PURPOSE: This study aims to comprehensively evaluate the diagnostic value of quantitative parameters extracted from apparent diffusion coefficient (ADC) maps in distinguishing fibroepithelial tumors using whole-tumor histogram and texture analysis. MATERIALS AND METHODS: This retrospective study included 66 female patients with single phyllodes tumor (PT) and 29 female patients with single fibroadenoma (FA) who underwent preoperative magnetic resonance imaging. By independently performing whole-tumor histogram and texture analysis based on ADC maps, two radiologists extracted seven histogram parameters and four texture parameters. The extracted parameters were compared using univariate analysis to determine their ability to distinguish FAs from PTs, benign PTs from FAs, as well as benign PTs from borderline and malignant PTs. RESULTS: When FAs and PTs were compared, ADC_skewness values of PTs were significantly lower than those of FAs (p < 0.05), whereas other significant extracted parameter values of PTs were significantly higher than those of FAs (p ≤ 0.001); the area under the curve of significant parameters combined was 0.936. Regarding the differences between FAs and benign PTs, ADC_SD, ADC_95th percentile and ADC_kurtosis of FAs were significantly lower than those of benign PT group, and ADC_skewness was higher than that of benign PT group (all p < 0.05). Furthermore, ADC_SD, ADC_95th percentile and all texture parameters are significantly higher in the borderline and malignant PT group than in FA and benign PT group (p < 0.05). In addition, ADC_kurtosis of malignant PT group was significantly lower than that of borderline PT group (p = 0.045). CONCLUSION: The extracted whole-tumor histogram and texture features of ADC maps can improve differential diagnosis of breast fibroepithelial tumors and contribute to optimal selection for clinical management of patients with fibroepithelial tumors.