PDF(Pubmed)
Abstract：
Initial diagnostic ultrasound of a 22-year-old female patient presenting with a palpable breast mass revealed a suspicious mass initially thought to arise from the breast. However, follow-up diagnostic mammography was normal without evidence of the 5 cm mass seen on ultrasound, and pathology results from ultrasound-guided core needle biopsy raised suspicion for giant cell tumor, making chest wall origin of the mass more likely. Further CT and MRI imaging indeed revealed a locally invasive mass arising from the anterior fifth rib. The patient was treated with denosumab to decrease tumor burden before surgery, and subsequently underwent successful surgical resection of the tumor with mesh overlay and flap reconstruction of the chest wall defect. This case highlights the importance of keeping chest wall lesions in the differential for lesions presenting clinically as breast lesions. Despite the rarity of giant cell tumor of the anterior rib and its unusual presentation as a breast mass, appropriate diagnostic imaging work-up allowed for successful diagnosis and treatment in this case.
摘要：
一名22岁女性患者的初步诊断超声表现出明显的乳房肿块，发现最初被认为是由乳房引起的可疑肿块。然而,随访诊断性乳房X线照相术是正常的，没有超声上看到的5厘米肿块的证据，超声引导下穿刺活检的病理结果增加了对巨细胞瘤的怀疑，使肿块的胸壁起源更有可能。进一步的CT和MRI成像确实显示了前第五肋骨引起的局部侵入性肿块。患者在手术前接受denosumab治疗以减轻肿瘤负担，随后进行了成功的手术切除的肿瘤与网片覆盖和皮瓣重建的胸壁缺损。此病例强调了将胸壁病变保留在临床上表现为乳腺病变的病变中的重要性。尽管前肋骨的巨细胞瘤很少见，而且表现为乳房肿块，在这种情况下，适当的诊断成像检查可以成功诊断和治疗。
