First case report of ruptured giant expanding breast oil cyst.

Background: Fat necrosis is a common sequelae of breast trauma. Its many presentations have been described in the literature. Oil cyst is one of the less common presentations of fat necrosis. Giant oil cyst is rare and may take many years to mature in an unstable environment of the women's breast. To our best knowledge, rupture of a giant oil cyst has never been reported. Yet, it should be included on the list of differential diagnoses along with hematoma, infection, or neoplasm. When a patient presents with an expanding breast lump, clinicians should be aware of the potential for oil cyst rupture and its features. Case Description: A 51-year-old woman presented to a breast clinic with concern of an expanding painless left breast lump for the last 4 months. The lump first appeared 12 years ago shortly after a car accident and was stable for many years. The initial left breast ultrasound was inconclusive, but diagnostic mammogram revealed a giant ruptured calcified oil cyst. Due to the availability of prior diagnostic images, we were able to retrospectively follow the unique sequelae of fat necrosis from the development of giant oil cyst shortly after the breast trauma and up to the final outcome of ruptured calcified oil cyst. Conclusions: Trauma to a woman's breast can lead to the formation of a large oil cyst which can remain present for years, peripherally calcify, and is susceptible to rupture. Clinicians should be aware of this potential complication when presented with the case of expanding breast lump. Diagnostic mammogram is a study of choice and demonstrates benign pathognomonic features of an oil cyst.

Giant phyllodes tumor of the breast: A case report.

Phyllodes tumors of the breast are rare fibroepithelial neoplasms that account for less than 1% of all breast tumors. They tend to affect middle-aged women, who present with a rapidly growing, palpable mass. Here we present a case of a 34-year-old female surrogate mother without any reported personal or family history of breast cancer who presented with a rapidly growing left breast mass, pathologically proven to be a phyllodes tumor. The patient was a G7P7 surrogate mother who received estrogen and progesterone injections for her twin surrogate pregnancy starting 4 months before embryo implantation, after which, she discovered a large palpable mass in the left breast at approximately week 7 gestational age. At the initial presentation, the patient was at week 23 gestational age. She underwent C-section delivery of the twins at this time and obtained further work-up of the mass. She had a core needle biopsy which yielded a benign fibroepithelial tumor. Due to the size of her breast mass and atypical morphology, including extension to the nipple, and skin ulceration, the patient subsequently underwent left mastectomy. At the time of mastectomy, which was 8 months after the initial work-up, the mass had grown to measure approximately 12 × 10 cm on physical examination and took up most of her left breast. It was completely resected and was pathologically determined to be a borderline phyllodes tumor. Only a few cases have been reported about the development of phyllodes tumor during pregnancy in the literature, and we believe this is the first case report of phyllodes tumor related to a surrogate pregnancy. Although the relationship between exogenous hormones and fibroepithelial tumors is not well understood, the case poses the clinical question if screening mammograms should be offered to patients undergoing exogenous hormonal therapy, regardless of age to establish a baseline and monitor for the development (if any) or growth of these tumors.

Cross-sectional imaging following surgical interventions for stress urinary incontinence in females.

Stress urinary incontinence (SUI) is a condition in which the weakness of the pelvic floor muscles causes unintentional loss of urine. For patients who are unable to achieve symptomatic improvement from lifestyle modification and pharmacotherapy, surgical placement of the pelvic slings or the use of urethral bulking agents has been shown to provide tremendous symptomatic improvement. Learning to recognize the pelvic slings and to identify their complications on imaging is invaluable; however, this is challenging because of the change in the local anatomy after surgical placement of the sling. In this paper, we present CT and MR imaging to demonstrate the surgical and non-surgical treatments of female SUI and their complications. Through this pictorial essay, our goal is to familiarize radiologists with recognizing the various forms of treatment for SUIs, the relevant pelvic anatomy, and complications that may occur secondary to the surgical placement of the pelvic slings.