DOI QR코드

DOI QR Code

유방촬영술에서 거친 석회화 종괴로 관찰된 점액 유방암: 증례 보고

Mucinous Breast Carcinoma Presenting as a Coarse and Densely Calcified Mass on Mammography: A Case Report

  • 신기원 (인제대학교 의과대학 부산백병원 영상의학과) ;
  • 박하영 (인제대학교 의과대학 부산백병원 병리과) ;
  • 박영미 (인제대학교 의과대학 부산백병원 영상의학과)
  • Gi Won Shin (Department of Radiology, Busan Paik Hospital, Inje University College of Medicine) ;
  • Ha Young Park (Department of Pathology, Busan Paik Hospital, Inje University College of Medicine) ;
  • Young Mi Park (Department of Radiology, Busan Paik Hospital, Inje University College of Medicine)
  • 투고 : 2019.04.25
  • 심사 : 2019.12.16
  • 발행 : 2020.09.01

초록

저자들은 유방촬영술에서 밀도 높고 거친 석회화 종괴로 관찰된 점액 유방암 증례를 보고한다. 병변은 초음파 영상에서 4.6 cm 크기의 고에코성, 후방음영 증강 및 석회화를 동반한 종괴로 관찰되었다. 이러한 영상의학적 소견은 점액암의 비특징적인 소견으로서, 연골형 분화의 화생성 암, 유방의 골외성 골육종, 연골육종 등에서 나타날 수 있는 소견으로 알려져 있다. 이 병변은 4년간 서서히 증가되는 양상으로 관찰되었으며 당시에는 이형성 석회화 양상으로 관찰되었다. 점액암을 포함한 몇 가지의 드문 아형의 유방암이 거친, 밀도 높은 석회화 종괴로 관찰될 수 있으므로, 즉각적인 생검이 고려되어야 할 것이다.

We report herein a 46-year-old woman who presented with mucinous breast carcinoma that appeared as a coarse and densely calcified mass on mammography. The lesion was a 4.6-cm-sized palpable, hyperechoic, calcified mass with posterior shadowing on ultrasonography. This finding is a unique feature of mucinous breast carcinoma and is also observed in unusual breast cancer variants such as metaplastic breast cancer with chondroid differentiation, extraosseous osteosarcoma, and breast chondrosarcoma. The lesion showed a slow-growing pattern throughout the 4-year observation period. Mammography performed 4 years ago revealed faint, grouped microcalcifications; the lesion increased in size over 2 years, presenting as a well-circumscribed, calcified mass, mimicking dystrophic calcification. As several unusual variants of breast cancer, including mucinous carcinoma, may present as coarse and densely calcified masses on mammography, immediate biopsy should be considered when they are observed.

키워드

참고문헌

  1. Tseng HS, Lin C, Chan SE, Chien SY, Kuo SJ, Chen ST, et al. Pure mucinous carcinoma of the breast: clinicopathologic characteristics and long-term outcome among Taiwanese women. World J Surg Oncol 2013;11:139
  2. Zhang L, Jia N, Han L, Yang L, Xu W, Chen W. Comparative analysis of imaging and pathology features of mucinous carcinoma of the breast. Clin Breast Cancer 2015;15:e147-154 https://doi.org/10.1016/j.clbc.2014.11.005
  3. Pina Insausti LJ, Soga Garcia E. Mucinous breast carcinoma showing as a cluster of suspicious microcalcifications on mammography. Eur Radiol 1998;8:1666-1668 https://doi.org/10.1007/s003300050608
  4. Ellis IO, Galea M, Broughton N, Locker A, Blamey RW, Elston CW. Pathological prognostic factors in breast cancer. II. Histological type. Relationship with survival in a large study with long-term follow-up. Histopathology 1992;20:479-489 https://doi.org/10.1111/j.1365-2559.1992.tb01032.x
  5. Cardenosa G, Doudna C, Eklund GW. Mucinous (colloid) breast cancer: clinical and mammographic findings in 10 patients. AJR Am J Roentgenol 1994;162:1077-1079 https://doi.org/10.2214/ajr.162.5.8165985
  6. Conant EF, Dillon RL, Palazzo J, Ehrlich SM, Feig SA. Imaging findings in mucin-containing carcinomas of the breast: correlation with pathologic features. AJR Am J Roentgenol 1994;163:821-824 https://doi.org/10.2214/ajr.163.4.8092016
  7. Song Y, Liu X, Zhang G, Song H, Ren Y, He X, et al. Unique clinicopathological features of metaplastic breast carcinoma compared with invasive ductal carcinoma and poor prognostic indicators. World J Surg Oncol 2013;11:129
  8. Velasco M, Santamaria G, Ganau S, Farrus B, Zanon G, Romagosa C, et al. MRI of metaplastic carcinoma of the breast. AJR Am J Roentgenol 2005;184:1274-1278 https://doi.org/10.2214/ajr.184.4.01841274
  9. Rizzi A, Soregaroli A, Zambelli C, Zorzi F, Mutti S, Codignola C, et al. Primary osteosarcoma of the breast: a case report. Case Rep Oncol Med 2013;2013:858705
  10. Yildirim Erdogan N, Huten ON, Bahadir F, Sander E. Diffuse and psammomatous calcification in intestinal type gastric carcinoma: report of two cases with literature review. Turk J Gastroenterol 2011;22:414-418 https://doi.org/10.4318/tjg.2011.0260