"Sein dans le sein": échographie et mammographie de l'hamartome

Abstract

We report a 20-year-old patient, mother of 2 children and with no personal or family history of breast disease who consulted for a painless right breast mass evolving for 6 months. The mass was firm, painless and mobile at the right inferior-external quadrant. No inflammatory signs, nipple discharge or associated axillary adenopathy. Breast ultrasonography revealed a tissue formation of 4x2x4cm, parallel to the skin plane, well limited, heterogeneous hypoechoic with hyperechoic trabeculae, and containing tubulated structures with echogenic content, without attenuation or reinforcement of the echoes (A). In color Doppler, its vascularization was identical to that of the normal mammary gland. In view of this aspect, a complementary mammography was performed. It allowed the visualization in the right inferior-external quadrant of a well-limited, encapsulated oval mass of mixed fat and glandular density, thus producing the image of "breast within the breast" (B, C). This allowed the diagnosis of mammary hamartoma. The mammary hamartoma is a pseudotumor (benign) consisting of fibrous tissue, adipose tissue and glandular element. It is a rare mammary disorder occurring at any age from puberty. In its typical form as in our patient, mammography is the key examination and is sufficient to establish the diagnosis even without biopsy. Its treatment does not require an excision except in the case of aesthetic discomfort. It should be noted that its differential diagnosis includes other benign mammary tumors of adolescents and young adults such as adenofibroma, phyllode tumor, lipoma and papilloma.