Inner Quadrant Of Right Breast Research Articles

27 Neuroendocrine tumour of the breast: A case report & Literature review

Abstract Introduction Neuroendocrine differentiation in breast carcinomas was first described by Feyrter and Hartmann in 1963, based on positive silver staining in mucinous carcinomas of the breast. NEBC are heterogeneous group of rare breast tumours which account for < 0.1 % of breast tumour and < 1% of neuroendocrine tumours. Case A 65-year-old female presented with a 12 x 10 cm non-tender hard globular slightly mobile mass in upper medial /inner quadrant of right breast with overlying 2 cm scar mark and bilateral axillary lymphadenopathy. Mammography revealed a BIRADS-4 lesion and FNAC showed atypical cells. Octreotide Scan showed that the mass was neuroendocrine in origin. Further CT imaging showed no other site for metastasis. She was managed with a Right sided modified radical mastectomy (MRM) after multidisciplinary team (MDT) decision. Biopsy of the Lesion showed ER, PR receptor & synaptophysin receptor positivity, negative Her 2-neu status, ki-67 proliferation index of 10% & grade II NET. Conclusion Primary neuroendocrine tumours of the breast are infrequent tumours that appear in women aged 60–70 years. Their diagnosis is complex as they lack defining clinical and radiological characteristics. Their low incidence makes it impossible to establish an optimal treatment protocol.

A Rare Occurrence of Ewing’s Sarcoma Presenting as Breast Mass: A Case Report and Literature Review

Ewing’s sarcoma (EWS) typically involves the bony structures in adolescents and young adults. Extraskeletal sarcoma is a rare, aggressive, and malignant soft-tissue tumor with high recurrence rate. EWS of the breast is a rare entity with <1% cases reported in literature. A 55-year-old lady who complained of the gradual onset painless breast lump lasting for 1 year was referred to our institute in August 2021. Diagnostic ultrasound of bilateral breast identified a cystic lesion measuring 1.8 × 1.5 cm in lower inner quadrant of right breast. Diagnostic excisional biopsy of the right breast lump, which was conducted outside of the institute, showed malignant small round cell tumor. Post-excisional biopsy whole body 18-fluoro-deoxy-glucose positron emission tomography showed no residual uptake with no evidence of metastatic disease elsewhere. Immunohistochemistry work revealed positive expression of NKX2.2 and MIC2, which is consistent with the histopathological feature of EWS. Fluorescent in situ hybridization showed EWSR1 rearrangement, which is consistent with the diagnosis of EWS. The patient underwent a wide local excision of the right breast, followed by adjuvant chemotherapy consisting of 18 weekly vincristine/adriamycin D/cyclophosphamide regimen (vincristine, total dose of 2 mg; adriamycin D 100 mg; and cyclophosphamide 1.6 g). The patient was disease free after follow-up of 1 year. The rarity of primary breast EWS poses a diagnostic dilemma and hence the treatment. Local control with systemic therapy is the cornerstone of the treatment, in which breast conservation surgery is equivalent to mastectomy in patient with a good/average breast volume.

Hydatid Cyst of Breast: A Case Report

Hydatid cyst is a zoonotic disease which occurs due to infectivity with larval stage of Echinococcus granulosus. The disease is chronic and cysts can be lodged in different organs. It has cosmopolitan distribution and impact health and economical challenges for many countries throughout the world. The location of the disease is mostly in the liver and lungs. Hydatid disease of breast is extremely rare. A case report of 24 year female with the diagnosis of the hydatid breast is described in detail. The patient presented with painless lump in the upper inner quadrant of right breast of two months duration. History of trauma, pus discharge, itching, weight loss, fever or hormonal therapy were absent. The patient was diagnosed preoperatively as cysticercosis right breast by fine needle aspiration cytology based on the laboratory results conducted outside the hospital. However, histopathology confirmed the diagnosis of hydatid breast. It is the second diagnosed case in Nepal. Therefore, accurate information on the distribution of the disease is first step for the control and prevention. Only few reports are published in the literature about breast hydatid cyst.Thus, we want to emphasize the importance of keeping hydatid disease in differential diagnosis of cystic breast lesions, particularly in endemic region, where the disease could mimic fibroadenoma, phyllodes tumors, chronic abscesses.Journal of Nepalgunj Medical College Vol.12(1) 2014: 41-42