Painful Schwannoma of the Breast Completely Removed by a Vacuum-Assisted Device With Symptom Resolution

摘要

A 41-year-old woman referred to our institution with a small painful lump in the inferior-outer quadrant of the right breast. She noticed it some months before and she reported hyperaestesia and intense tenderness at that site. No personal or familiar history of breast disease or assumption of hormonal replacement therapy was elicited at anamnesis. On physical examination, a 5 mm smooth, mobile, painful mass was revealed in the inferior-outer quadrant of the right breast. There was no evidence of axillary lymphadenopathy and the patient did not present any feature of Von Recklinghausen's syndrome.Mammography showed bilateral heterogeneously dense breast tissue (ACR breast density category 3) and did not reveal any suspicious finding. In the place of palpable nodule, in the inferior-outer quadrant of the right breast, close to the pectoralis muscle, sonography revealed an oval, well-demarcated lesion of 5 mm, with mixed echogenicity, constituted of a hypoechoic, solid part and an anechoic cystic portion(Fig. la). Color Doppler sonography showed very rich parietal vascularization (Fig. 1b). These features led to the suspicion of a papillary lesion and brought us to attempt removal of all evidence of the lesion to obtain histologic diagnosis and pain relief. Ten milliliter of lidocaine was locally injected before the procedure to avoid patient discomfort.