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Fig. l.-41-year-old woman with Kasabach-Merritt syndrome with multiple left breast masses. A, Mediolateral oblique radiograph of left breast shows manywell-defined round highdensity masses that obscure fibroglandular tissue. Note phleboliths. B, Sonogram of left breast shows cystic septated lesion with echogenic area of calcification corresponding to phlebolith (arrow). C, Sagittal MR image of left breast obtained using 12-weighted fast spin-echo sequence with fat saturation shows breast hemangiomas as hyperintense areas with well-defined round or lobular margins (straightsolidarrows).
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Cholesterol granuloma (CG) is an extremely rare benign condition that should be considered in the differential diagnosis of breast lesions suspected of being malignant. We present a case of a 55-year-old woman who presented with a nodule mass in the upper external quadrant of the right breast on a routine mammography examination. The described case...
Citations
... Occasionally, phleboliths may be a suspicious finding to distinguish the hemangioma from angiosarcom. [8] However, the diagnosis of breast angiosarcoma virtually depends on the presence of malignant cells on histopathologic study. As for the differentiation from typical breast cancer, our presented case corresponds with the young age group as previous reported, along with the presence of thrombocytopenia and anemia due to the Kasabach-Merrit syndrome. ...
Introduction
Primary breast angiosarcoma with spontaneous intratumoral bleeding associating with Kasabach-Merritt Syndrome is rarely reported.
Case Findings/Patient Concerns
We herein present such a case in a 30-year-old pregnant woman who was initially diagnosed to hemangioma at her early gestation. However, the sudden rapid tumor growth was aware of the attention and intended for receiving the breast enhanced magnetic resonance imaging.
Diagnoses and Interventions
The dynamic MRI enhancement showed inhomogenous enhancement at the periphery of the lobulated tumor on both early and delayed scans, otherwise a large hematoma was revealed at the center. Surgical resection was performed after baby delivery by Caeserean section, and histopathologic study confirmed breast angiosarcoma.
Conclusion
Despite its rarity, clinicians should recognize the association of breast angiosacroma with Kasabach-Merritt Syndrome with suggestive finding of enhanced MRI in order to decide the surgical approach.
... On ultrasonography, cavernous hemangiomas might present as solid, hypoechoic or cystic areas with small bright echoes due to calcification and fibrous septations (17)(18)(19). However, it may be isoechoic with surrounding tissue thus remaining undetected. ...
Although the observation of breast vascular tumors is rare, the most common tumor is hemangıoma in the benign group, and these tumors are observed incidentally in lumpectomy or mastectomy specimens during histological examinations. They are classified into capillary, cavernous, and venous hemangıomas. Cavernous hemangıoma is the most common subtype. Cavernous hemangıomas are benign vascular tumors, which malformatıon from mature blood vessels. Hemangıomas ın the benıgn group may show a suspicion of ductal carcinoma in situ (DCIS) in mammographic analysis. Ultraso-nography (US) and magnetic resonance ımagıng (MRI) are the most useful imaging methods for analyzing the structure of breast vessels. In this case, a 54-year-old female who have any complaint. Scanning mammography (MG) detected the tumor, but physıcal examınatıon and US could not identify the mass. According to the MG analysis, the lesion was evaluated as BIRADS 4b, and the patient underwent excisional biopsy after wire localization. Pathological analysis revealed cavernous hemangıoma.
... Os hemangiomas capilares são tumores vasculares benignos caracterizados por proliferação de vasos capilares (4) . O hemangioma da mama afeta principalmente mulheres pós-menopáusicas e pode aumentar de tamanho na reposição hormonal (5) . ...
Hemangioma de mama é um tumor benigno raro que apresenta pouca ou nenhuma captação de 18F-flúor-2-deoxi-Dglicose (FDG) na tomografia por emissão de pósitrons (PET). Relatamos um nódulo mamário compatível, patologicamente, com hemangioma, em uma mulher cuja PET scan demonstrou captação elevada de FDG (simulando tumor maligno). Também fizemos breve revisão das causas que levam a resultados falso-positivos e falso-negativos pela PET.
... Le cas d'un hémangiome et d'un fibroadénome coexistant dans le tissu adjacent a été rapporté mais cette association semble fortuite [9]. La découverte de multiples hémangiomes mammaires a été observée chez une patiente présentant un syndrome de Kasabach-Merritt qui désigne l'association d'une thrombopénie et d'un volumineux hémangiome [10] [11]. La mammographie systématique constitue le mode de découverte habituel, plus rarement, c'est une masse palpable ...
... À l'IRM, peu de descriptions ont été rapportées jusqu'à présent. L'hypersignal lésionnel en pondération T2 est retrouvé dans la majorité des cas, comme dans nos deux observations [3] [5] [10] [18] [19]. Un volumineux hémangiome en hyposignal T2 a, cependant, été rapporté [20]. ...
... Après injection de gadolinium, le rehaussement des hémangiomes ne semble pas caractéristique au vu des rares publications concernées [3,10,18—20]. Une prise de contraste périphérique, comme dans nos deux observations , est cependant décrite dans deux cas [10] [20]. Un rehaussement débutant au centre de la masse a également été rapporté [19]. ...
... Cavernous haemangiomas are the most common form of mammary haemangioma, but there are only a few published reports regarding this tumour. Most reported cases pertained to the localized form of mammary haemangioma [1,[4][5][6] and associated calcifications [1,[4][5][6][7]. In this study, we describe a case with unilateral whole breast involvement without associated calcifications, studied with mammography, ultrasound and MRI. ...
... Most haemangiomas have well-circumscribed borders grossly, but microscopically the vascular channels may blend with the surrounding breast parenchyma [2]. Microscopic examination reveals dilated vessels congested with red blood cells, separated by fibrous septa, and with extensive fibrosis and sometimes with phleboliths [2,7]. ...
... The reported mammographic appearance of a cavernous haemangioma is of a well-defined, lobulated mass that may have fine or coarse calcifications [1,[4][5][6][7]. Coarse or egg-shell macrocalcifications indicate phleboliths. ...
Vascular tumours of the breast are rare and most can be classified as either angiosarcomas or haemangiomas. Cavernous haemangiomas are the most common form of mammary haemangioma. We describe a case with unilateral whole breast involvement without associated calcifications, studied with mammography, ultrasound and MRI.
... 6 Other types of hemangioma are rare. 1 The mammographic appearance of hemangiomas has been reported as a well-defined, lobulated mass showing fine microcalcifications or coarse, bizarre calcifications. [7][8][9][10][11][12][13] The sonographic appearance of a breast hemangioma has been described as a poorly defined, hyperechoic mass with marked distal attenuation or a well-defined, solid, mainly hypoechoic lesion. 7,9,14 Some lesions may contain small, bright echoes consistent with areas of calcification. ...
Vascular tumors of the breast are uncommon, and most are angiosarcomas. Benign hemangiomas of the breast are rare, and there are few reports. We report a case of a breast subcutaneous hemangioma in which skin redness ad recently developed and high vascularity was shown on power Doppler sonography.
Kasabach-Merritt syndrome (KMS) consists of a clinical trial of capillary hemangioma, thrombocytopenia and disseminated intravascular coagulation. KMS occurs most commonly in the pediatric population, and its occurrence in adults is rare. Specific guidelines or randomized clinical trials guiding clinical management of KMS in adult patient are lacking. This manuscript provides a comprehensive review of KMS and discusses recent advances in the medical management of KMS. We also propose a systematic therapeutic approach which would serve as a guide in the management of adult patients with KMS caused by hemangiomas.
