PDF(Pubmed)
Abstract：
Extramammary masses are infrequently encountered in breast examinations. They may occur in the chest wall and axilla as neighbors of the breast. It is important to determine the nature of the lesion. However, some benign tumors, such as granular cell tumors (GCTs), also show malignant characteristics, which leads to misdiagnosis. To the best of our knowledge, multimodal ultrasound features of GCT have not been elucidated. We report two cases of women with GCTs encountered upon breast cancer screening; the tumor was not located in breast tissue. The first patient was a 37-year-old woman who presented with a slow-growing mass in the right breast and the GCT was located in the pectoralis major muscle. The second patient was a 52-year-old woman who presented with a palpable left axillary mass and the GCT was located in the axilla. Mammography failed to detect the masses in the two patients upon breast cancer screening. However, two-dimensional ultrasonography revealed a solid heterogeneous hypoechoic mass. Shear wave elastography showed that the masses had an increased hardness compared with the surrounding tissue. Further contrast-enhanced ultrasonography showed that the contrast patterns of the two masses were different. In case one, contrast-enhanced ultrasonography showed an inhomogeneous annular high enhancement, and the dynamic curve showed rapid enhancement and regression. In case two, contrast enhanced ultrasound showed slight enhancement around the lesion but no enhancement inside. Postoperative pathology confirmed that the GCT was benign in both cases. The patients showed no signs of recurrence at the 2-year follow-up. Here, we report two cases and present the multimodal ultrasonography findings of this tumor for the first time. Radiologists and surgeons should be aware of these imaging manifestations and include them in their differential diagnoses.
摘要：
在乳房检查中很少遇到乳房外肿块。它们可能发生在胸壁和腋窝，作为乳房的邻居。确定病变的性质很重要。然而,一些良性肿瘤,如颗粒细胞瘤（GCT），也表现出恶性特征，导致误诊。据我们所知,GCT的多模态超声特征尚未阐明。我们报告了2例乳腺癌筛查中遇到的GCTs女性；肿瘤不在乳腺组织中。第一位患者是一名37岁的女性，她的右乳房肿块缓慢增长，GCT位于胸大肌。第二名患者是一名52岁的女性，她表现出明显的左腋窝肿块，GCT位于腋窝。乳房X线照相术未能在乳腺癌筛查后检测到两名患者的肿块。然而,二维超声检查显示固体异质低回声肿块。剪切波弹性成像显示，与周围组织相比，肿块的硬度增加。进一步超声造影显示两个肿块的造影模式不同。万一有,超声造影显示不均匀的环形高度增强，动态曲线显示快速增强和回归。如果是两个，超声造影显示病变周围轻微增强，但内部无增强。术后病理证实两例GCT均为良性。在2年的随访中，患者没有复发的迹象。这里,我们报告了2例病例，并首次介绍了该肿瘤的多模态超声检查结果。放射科医生和外科医生应了解这些影像学表现，并将其纳入鉴别诊断中。
