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CASE REPORT |
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| Year : 2011 | Volume
: 56
| Issue : 3 | Page : 313-314 |
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| Fibromatosis of breast mimicking sarcoidosis |
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Silonie Sachdeva
Department of Dermatology, Carolena Skin, Laser & Research Centre, Jalandhar, Punjab, India
| Date of Web Publication | 30-Jun-2011 |
Correspondence Address:
Silonie Sachdeva
Carolena Skin, Laser & Research Centre, Jalandhar, Punjab-144002
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0019-5154.82489
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 Abstract | | |
Primary mammary fibromatosis is a rare skin condition which can arise after trauma or previous surgery. The exact etiology is unknown. Very few cases have been reported in literature and the main emphasis is to differentiate this condition from breast carcinoma. We report here an unusual case of a 60 year old female who presented with skin lesion which clinically looked sarcoid with history suggestive of sarcoidosis, but on histopathology fibromatosis of breast was revealed. Complete work up ruled out any carcinomatous changes. Surgical excision of the lesion was done with no recurrence seen in one year follow up period.
Keywords: Fibromatosis, carcinomatous, sarcoidosis
How to cite this article:
Sachdeva S. Fibromatosis of breast mimicking sarcoidosis. Indian J Dermatol 2011;56:313-4 |
| Introduction | |  |
Primary localized fibromatosis of breast is defined as locally invasive, noncapsulated and well-differentiated fibroblastic growth which arises within the mammary gland. It has no metastatic potential. We report here a case of 60-year-old female presenting with fibromatosis breast mimicking sarcoid lesions.
| Case Report | | |
A 60-year-old female presented with the chief complaint of 6 month's history of painless, raised, and gradually increasing lesion on the left breast. There was no history of any trauma, radiation therapy, or previous surgery of the breast. There was no history of any milky or bloody discharge. There was history of breathlessness associated with the lesion. There was no history of breast cancer in the patient or her family. On local examination, a well-defined plaque, skin-colored with slight erythema, firm to hard in consistency, with dimpling and tethering of the skin was present [Figure 1]. Clinically, provisional diagnosis of sarcoidosis breast was made. Routine investigations were normal. Patient was advised chest X-ray and mammography of the breast. The chest X-ray was normal with little increase in hilar shadow on the left side, which was not significant. The mammogram showed a high-density spiculated mass. Fine needle aspiration cytology (FNAC) from the lump was negative for any cancer cells. A small 4-mm punch biopsy was taken from the edge of the plaque and histopathology revealed spindle cell formation in the lower dermis along with fibroblast proliferation and deposition of homogenous eosinophilic material and collagen deposition. The findings were consistent with the fibromatosis of the breast [Figure 2]. Patient was referred to surgery department and complete excision of the lesion was done. Follow up examination a year later did not show any recurrence. | Figure 1: A well-defined plaque, skin colored, with dimpling and tethering of the skin
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 | Figure 2: Histopathology under 10× showing spindle cell formation in the lower dermis along with fibroblast proliferation and deposition of homogenous eosinophilic material and collagen deposition
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| Discussion | | |
Primary fibromatosis of the breast is a rare neoplasm which accounts for less than 0.2% of all the breast neoplasms. [1] A history of trauma to the breast is common, but it may arise de novo as in our patient. The etiology of the disease is unknown, but it has been reported to occur in patients with Gardner syndrome and familial multicenteric fibromatosis. [2],[3] Clinical presentation is a hard painless lump associated with dimpling and tethering of the skin and retraction of the nipple. [4] Classical clinical presentation was present in our case except retraction of nipple. Since patient complained of breathlessness, we initially thought it to be a sarcoid lesion on the breast. Ojeda et al. reported that in sarcodosis breast, the most common clinical finding is a nontender, firm, mobile breast mass without evidence of skin or nipple changes. [5] Thus, fibromatosis of breast can clinically mimic sarcoidosis. However, biopsy findings in our case were consistent with fibromatosis which is benign mesenchymal tumor of the breast and includes spindle cell formation in the lower dermis. Mammography findings as in our case can most frequently mimic a breast carcinoma and has been reported in past, [6] so, performing an FNAC is must which was negative in our case. Treatment of fibormatosis consists of initial excision biopsy followed by wider excision. Local recurrence is common, so, regular follow up is necessary. [7] Our patient has shown no recurrence for the past 1 year after treatment. This case is being reported so that for its unique clinical presentation in which fibromatosis almost mimicked sarcoidosis breast and to emphasize the role of histopathological findings in such cases.
| References | | |
| 1. | Haagensen CD. Diseases of the Breast. 2 nd ed. Philidelphia: Saunders; 1971. 
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| 2. | Haggit RC, Booth JL. Bilateral fibromatosis of the breast in Gardner's syndrome. Cancer 1970;25:161-6.
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| 3. | Zayid I, Dihmis C. Familial multicentric-desmoids: Report of three cases in the jordianian family. Cancer 1969;24:786-95.
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| 4. | Wargotz ES, Norris HJ, Austin RM, Enzinger FM. Fibromatosis of the breast: A clinical and pathological study of 28 cases. Am J Surg Pathol 1987;11:38-45.
[PUBMED] |
| 5. | Ojeda H, Sardi A,Totoonchie A. Sarcoidosis of the breast: Implications for the general surgeon. Am Surg 2000;66:1144-8.
[PUBMED] |
| 6. | Cederlund CG, Gustavsson S, Linell F, Moquist-Olsson I, Andersson I. Fibromatosis of the breast mimicking carcinoma at mammography. Br J Radiol 1984;57:98-101.
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| 7. | Rosen PP, Ernsberger D. Mammary fibromatosis: A benign spindle cell tumour with significant risk of local recurrence. Cancer 1989;63:1363-9.
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[Figure 1], [Figure 2] |
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