Breast fibromatosis mimicking breast carcinoma.

Fibromatosis arising from the breast, also referred to as desmoid tumor, aggressive fibromatosis, or low-grade fibrosarcoma, is a rare benign entity, accounting for only 0.2% of all breast tumors. Associations with familial multicentric fibromatosis and trauma, including that resulting from surgical intervention, have been reported. Awareness of this lesion is important, as the diagnosis has often been confused with that of breast carcinoma. We present the case of a 30-year-old white woman who presented with a palpable mass within the medial portion of her right breast. She reported breast carcinoma in both her paternal grandmother and maternal aunt. Subsequent mammographic and sonographic evaluation demonstrated an irregular solid mass within the posteromedial portion of the right breast. Ultrasound-guided core needle biopsy revealed low-grade myofibroblastic proliferation consistent with breast fibromatosis. The lesion was surgically resected via wide local excision. Follow-up mammograms performed 1 and 2 years after resection demonstrated no radiographic evidence of recurrence.

Vibrio vulnificus necrotizing fasciitis preceding herpes zoster.

A 74-year-old white man presented with unilateral radicular pain extending across the left side of his chest and back. A diagnosis of postherpetic neuralgia, a sequela of herpes zoster, was made. Herpes zoster represents a reactivation of the varicella zoster virus that lies dormant in patients with past chickenpox. Risk factors for the disease include advanced age, stress, immunodeficiency, and immunosuppression. Treatment of herpes zoster entails traditional antiviral medications, while prevention may be achieved with a new prophylactic vaccine.

Invasive mucinous carcinoma of the breast.

Mucinous carcinoma of the breast is one of the rarer forms of intramammary cancer, often presenting as a lobulated, fairly well circumscribed mass on mammography, sonography, and gadolinium-enhanced magnetic resonance imaging. It accounts for 1% to 7% of all breast cancers and generally carries a better prognosis than other types of malignant breast cancers. Metastatic disease occurs at a lower frequency than in other types of invasive carcinoma. We present an atypical case of mucinous carcinoma in a woman who presented with a palpable intramammary lymph node metastasis from an unknown breast primary. Subsequent magnetic resonance imaging and percutaneous biopsy demonstrated histologic findings consistent with a mixed mucinous neoplasm with a micropapillary pattern.

Lymphoma in the breast.

Lymphoma is a rare neoplasm in the breast. In this location, it may be primary or secondary, depending on whether there is lymphoma elsewhere in the body. The most common presentation of breast lymphoma is a painless palpable mass, indistinguishable from that of breast carcinoma, although the treatment regimens for these two neoplasms differ vastly. Knowledge of the varied mammographic and sonographic presentations of breast lymphoma should prompt more frequent recognition of this unusual malignant entity. Proper diagnosis of this neoplasm is of the utmost importance to guide appropriate treatment planning and prevent unnecessary and potentially harmful surgery. We describe secondary breast lymphoma in a woman who had been diagnosed and treated for non-Hodgkin's lymphoma several years earlier.

Inflammatory breast carcinoma.

Inflammatory breast carcinoma is a rare form of invasive breast cancer often characterized by erythema, warmth, and a classic "peau de orange" or "orange peel" appearance of the affected breast. The average age of onset is within the fourth and fifth decades. Lesions are usually detected and evaluated with mammography, sonography, and recently, breast magnetic resonance imaging. We present the case of a 49-year-old woman with inflammatory breast carcinoma in her left breast and describe the imaging appearance of this aggressive lesion on the modalities listed above. Because this lesion may be misdiagnosed as infection (i.e., mastitis) or as the sequelae of a dermatologic disorder, proper characterization of inflammatory breast carcinoma is of the utmost clinical and radiologic importance.

Fat necrosis in the breast from methylene blue dye injection.

Sentinel lymph node biopsy has become the standard of clinical care in staging axillary lymph nodes for breast carcinoma. While deemed safe and effective, methylene blue dye has been associated with infection, fibrosis, and skin and fat necrosis. The variable appearance of surgical dye-related fibrosis and fat necrosis on imaging studies poses a challenge to both radiologists and clinicians. We present a patient in whom a new enhancing lesion was visualized on follow-up magnetic resonance imaging for known breast carcinoma in the setting of neoadjuvant chemotherapy.

Carcinoma of the breast in men.

Male breast cancer is an uncommon disease of uncertain etiology. We describe a 66-year-old man who presented with a palpable mass in the left breast with associated nipple inversion. Mammographic images demonstrated a spiculated mass within the subareolar left breast at the palpable area of concern. Sonographic evaluation demonstrated a hypoechoic mass within the subareolar left breast at the location of the mammographic abnormality. The patient underwent an excisional biopsy and was subsequently diagnosed with high-grade invasive ductal carcinoma, the most common histologic type of carcinoma identified in men.

A pictorial review of complications of acute coalescent mastoiditis.

This case study highlights the extracranial and intracranial manifestations of severe otomastoiditis. A 35-year-old man presented with numerous symptoms, including ear and neck pain, headache, temporary vision loss, fever, malaise, and nausea and vomiting. Imaging studies led to the diagnosis of coalescent mastoiditis with septic dural sinus thrombosis, venous hemorrhagic infarctions, brain abscesses, and subdural empyema.