Pilomatrixoma of the breast, a rare lesion simulating breast cancer: a case report

摘要

Pilomatrixoma or calcifying epithelioma of Malherbe is a rare, benign, skin tumour originating from piliferous follicles; breast localization is considered to be very rare. These lesions can origin from the peri-areolar piliferous bulbs and, due to the clinical and imaging features, be easily misdiagnosed as a breast neoplasm. We present a case of pilomatrixoma of the left breast in a woman of 43 years appearing as a firm, deep nodule in the external quadrants. The lesion had mammographic and sonographic malignant features, but histological analysis on core-needle biopsy and surgical specimens revealed this unusual benign lesion. Keywords: breast, breast pilomatrixoma, breast calcified nodules, core needle biopsyCASE REPORTA 43-year old woman came to our Senology Department to be investigated for a centimetre sized, non-tender breast lump that had a hard consistency and was firm on the deep layers of the breast. The nodule was localized in the peri-areolar area at the confluence of the outer quadrants of the left breast. Physical examination of the axillae was negative.IMAGING FINDINGSMammography in two standard projections, cranio-caudal and medial-lateral-oblique (Fig. 1), showed, in a context of a dense breast, a round nodule containing a cluster of pleomorphic irregular microcalcifications that were classified as ACR BI-RADS IV–V. The size of the nodule was 12×11 mm. Open in a separate windowFigure 1 43 year old female with a hard, firm nodule at the confluence of the external quadrants of the left breast diagnosed as a breast pilomatrixoma after percutaneous and excisional biopsy.FINDINGS: nodular opacity in the external quadrants of the left breast of 12×11 mm, showing a cluster of pleomorphic irregular microcalcifications (ACR BI-RADS IV–V).TECHNIQUE: Analogic mammography (28 kV, 100 mAs), cranio-caudal (A) and medio-lateral oblique projections (B) of the left breast. Magnification views of cranio-caudal (C) and medio-lateral oblique (D) projections showing the lesion.