Korean J Radiol.  2010 Dec;11(6):687-691. 10.3348/kjr.2010.11.6.687.

Invasive Ductal Carcinoma in a Mammary Hamartoma: Case Report and Review of the Literature

• Choi N
• Ko ES

• KMID: 1119233
• DOI: http://doi.org/10.3348/kjr.2010.11.6.687

Abstract

Mammary hamartomas are typically a benign condition and rarely develop into malignant lesions. Only 14 cases of carcinomas associated with a hamartoma have been documented in the literature. In this case report, we describe a case of invasive ductal carcinoma within a hamartoma in a 72-year-old woman. Mammography, ultrasonography, and magnetic resonance imaging showed the features of a typical hamartoma with a suspicious mass arising in it. This case illustrates the importance of identification of unusual findings in a typical mammary hamartoma on radiologic examinations.

Keyword

Mammary hamartoma; Invasive ductal carcinoma

MeSH Terms

Aged
Breast Neoplasms/*diagnosis/surgery
Carcinoma, Ductal, Breast/*diagnosis/surgery
Diagnosis, Differential
Female
Hamartoma/*diagnosis/surgery
Humans
Magnetic Resonance Imaging
Mammography
Mastectomy, Modified Radical
Neoplasm Invasiveness
Ultrasonography, Mammary

Figure

• 

  Fig. 1 Invasive ductal carcinoma and mammary hamartoma in 72-year-old woman. A, B. Mediolateral oblique and craniocaudal views of right breast show fat-containing mass including dystrophic calcifications, suggesting hamartoma. There is focal asymmetry (arrows) at 12 o'clock within hamartoma. C. US of right breast at 12 o'clock shows spiculated, nonparallel, hypoechoic mass, which corresponds with focal asymmetry on mammogram (A, B). D, E. Standard subtraction image (D) and reverse subtraction image (E) of dynamic MRI show suspicious mass (arrows) within hamartoma, which was early enhanced (D) and washout (E). F. Gross specimen shows 9-cm smooth circumscribed fatty mass. Suspicious mass was excised from fatty mass (arrow). G, H. Photomicrograph of histopathologic specimen of excised suspicious mass reveals invasive ductal carcinoma and dystrophic calcifications (in H) located within carcinoma.

Reference

1. Stavros AT. Breast ultrasound. 2004. Philadelphia: LWW;560–569.

2. Mester J, Simmons RM, Vazquez MF, Rosenblatt R. In situ and infiltrating ductal carcinoma arising in a breast hamartoma. AJR Am J Roentgenol. 2000. 175:64–66.

3. Mendiola H, Henrik-Nielsen R, Dyreborg U, Blichert-Toft M, Al-Hariri JA. Lobular carcinoma in situ occurring in adenolipoma of the breast. Report of a case. Acta Radiol Diagn (Stockh). 1982. 23:503–505.

4. Baron M, Ladonne JM, Gravier A, Picquenot JM, Berry M. Invasive lobular carcinoma in a breast hamartoma. Breast J. 2003. 9:246–248.

5. Coyne J, Hobbs FM, Boggis C, Harland R. Lobular carcinoma in a mammary hamartoma. J Clin Pathol. 1992. 45:936–937.

6. Kai M, Tada K, Tamura M, Gomi N, Horii R, Akiyama F, et al. Breast cancer associated with mammary hamartoma. Breast Cancer. 2009. [Epub ahead of print].

7. Lee EH, Wylie EJ, Bourke AG, Bastiaan De Boer W. Invasive ductal carcinoma arising in a breast hamartoma: two case reports and a review of the literature. Clin Radiol. 2003. 58:80–83.

8. Pervatikar SK, Rao R, Dinesh US, Parameswaraiah S. Large mammary hamartoma with focal invasive ductal carcinoma. Indian J Pathol Microbiol. 2009. 52:249–251.

9. Ruiz-Tovar J, Reguero-Callejas ME, Aláez AB, Ramiro C, Rojo R, Collado MV, et al. Infiltrating ductal carcinoma and ductal carcinoma in situ associated with mammary hamartoma. Breast J. 2006. 12:368–370.

10. Tse GM, Law BK, Pang LM, Cheung HS. Ductal carcinoma in situ arising in mammary hamartoma. J Clin Pathol. 2002. 55:541–542.

11. Anani PA, Hessler C. Breast hamartoma with invasive ductal carcinoma. Report of two cases and review of the literature. Pathol Res Pract. 1996. 192:1187–1194.

12. Kuroda N, Sugimoto T, Numoto S, Enzan H. Microinvasive lobular carcinoma associated with intraductal spread arising in a mammary hamartoma. J Clin Pathol. 2002. 55:76–77.

13. Arrigoni MG, Dockerty MB, Judd ES. The identification and treatment of mammary hamartoma. Surg Gynecol Obstet. 1971. 133:577–582.

14. Daya D, Trus T, D'Souza TJ, Minuk T, Yemen B. Hamartoma of the breast, an underrecognized breast lesion. A clinicopathologic and radiographic study of 25 cases. Am J Clin Pathol. 1995. 103:685–689.

15. Helvie MA, Adler DD, Rebner M, Oberman HA. Breast hamartomas: variable mammographic appearance. Radiology. 1989. 170:417–421.

16. Chao TC, Chao HH, Chen MF. Sonographic features of breast hamartomas. J Ultrasound Med. 2007. 26:447–452.

17. Park SY, Oh KK, Kim EK, Son EJ, Chung WH. Sonographic findings of breast hamartoma: emphasis on compressibility. Yonsei Med J. 2003. 44:847–854.