Breast myofibroblastoma: Report of two cases with literature review

Year 2020, , 429 - 431, 01.05.2020

Malek Bouhani , Olfa Adouni İkram Marghli Molka Chemlali Riadh Chargui Khaled Rahal

https://doi.org/10.28982/josam.568688

Abstract

Myofibroblastoma (MFB) is a rare mesenchymal benign tumor that arises from the stromal structures of the breast tissue. It occurs in the elderly without sex predilection. Its clinical and radiological presentations are aspecific, thus MFB may be confounded with other malignant and benign breast lesions. However, the main histological characteristic of MFB is the presence of spindle cells in a collagenous background. In immunohistochemistry, MFB is positive for vimentin and CD34 with a noticeable low mitotic activity. Surgical excision remains the treatment cornerstone, with excellent outcomes. We retrospectively reviewed the records of all the patients who underwent surgery of breast from 01 January 2012 to 31 December 2018. We found two cases of breast myofibroblastoma. The first was a young woman aged 17 years, and the second was a male aged 87 years. The main symptom was a palpable breast lump in both patients. The radiological work up concluded to a benign lump in the young woman, and a suspicious breast lump in the man, to whom we performed a core biopsy. Histology staining showed the features of MFB. The woman underwent a lumpectomy, and the man underwent a mastectomy. Final histological staining showed spindle cells with a collagen matrix. The cells were positive for CD34, vimentin, and actin. Those features were compatible with the diagnosis of breast MFB. The aim of this report was to describe the clinical, radiological and histological features of breast MFB.

Keywords

Myofibroblastoma, Breast, Spindle cell

Meme miyofibroblastik: Literatür taraması ile iki olgu sunumu

Abstract

Miyofibroblastom (MFB), meme dokusunun stromal yapılarından kaynaklanan nadir bir mezenkimal benign tümördür. Cinsiyet farkı olmadan yaşlılarda daha sık görülür. Klinik ve radyolojik sunumları özgündür, bu nedenle MFB diğer malign ve benign meme lezyonlarıyla karıştırılabilir. Bununla birlikte, MFB'nin ana histolojik özelliği, iş mili hücrelerinin kollajen zemininde varlığıdır. İmmünohistokimyada MFB, belirgin düşük mitotik aktiviteye sahip vimentin ve CD34 için pozitiftir. Cerrahi eksizyon, mükemmel sonuçlarla tedavi temelini korumaktadır. 01 Ocak 2012 - 31 Aralık 2018 tarihleri arasında meme ameliyatı geçiren tüm hastaların kaydını retrospektif olarak inceledik. İki meme miyofibroblastom olgusu bulduk. Birincisi 17 yaşında genç bir kadındı, ikincisi 87 yaşında erkekti. Her iki hastada da ana semptom elle tutulur bir meme yumrusuydu. Radyolojik çalışma genç kadında iyi huylu bir tümör ile sonuçlandı, ancak erkekte görüntüler şüpheli bir tümör ortaya çıkardı. Adam için çekirdek biyopsi yaptık. Histoloji boyama MFB'nin özelliklerini gösterdi. Kadına lumpektomi, erkeğe mastektomi uygulandı. Son histolojik boyama, kollajen matriksli iğ hücrelerini gösterdi. Hücreler CD34, vimentin ve aktin için pozitifti. Bu özellikler meme MFB tanısı ile uyumluydu. Bu raporun amacı, meme MFB'nin klinik, radyolojik ve histolojik özelliklerini tanımlamaktı. 

Keywords

Myofibroblastom, Meme, İğ hücresi

References

• 1. Wagortz ES, Weiss SW, Norris HJ. Myofibroblastoma of the breast: sixteen cases of a distinctive benign mesenchymal tumor. Am J Surg Pathol. 1987;11:493–502.
• 2. Magro G. Mammary myofibroblastoma: a tumor with a wide morphologic spectrum. Arch Pathol Lab Med. 2008;132(11):1813–20.
• 3. Howitt BE, Fletcher CD. Mammary-type myobroblastoma: clinicopathologic characterization in a series of 143 cases. Am J Surg Pathol. 2016;40:361–7.
• 4. Magro G, Caltabiano R, Kacerovská D, Vecchio GM, Kazakov D, Michal M. Vulvovaginal myofibroblastoma: expanding the morphological and immunohistochemical spectrum. A clinicopathologic study of 10 cases. Hum Pathol. 2012;43(2):243–53.
• 5. Zhang Y, Jorda M, Goldblum JR. Perianal mammary-type myofibroblastoma. Ann Diagn Pathol. 2010;14:358–60.
• 6. Mukonoweshuro P, McCormick F, Rachapalli V, Natale S, Smith ME. Paratesticular mammary-type myofibroblastoma. Histopathology. 2007;50:396–7.
• 7. Scotti C, Camnasio F, Rizzo N, Fontana F, De Cobelli F, Peretti GM, et al. Mammary-type myofibroblastoma of popliteal fossa. Skeletal Radiol. 2008;37(6):549–53.
• 8. Comer JD, Cui X, Eisen CS, Abbey G, Arleo EK. Myofibroblastoma of the male breast: A rare entity with radiologic-pathologic correlation. Clinical imaging. 2017;42:109–12.
• 9. Reis-Filho JS, Faoro LN, Gasparetto EL, Totsugui JT, Schmitt FC. Mammary epithelioid myofibroblastoma arising in bilateral gynecomastia: Case report with immunohistochemical profile. Int J Surgical Pathol. 2001;9(4):331–4.
• 10. Sanmugasiva VV, Ramli MT, fadzli F, Kaur S, Abd Rahman N, Rahmat K. Myofibroblastoma of the breast. Malaysian J Pathol. 2018;40(3):349–53.
• 11. Khatib Y, Pandey V, Khade AL, Pandey R. Myofibroblastoma of the Breast: A Rare Cause of Breast Lump in a Postmenopausal Woman. J Midlife Health. 2018;9(1):47–9.
• 12. Yoo EY, Shin JH, Ko EY, Han BK, Oh YL. Myofibroblastoma of the female breast: Mammographic, sonographic, and magnetic resonance imaging findings. J Ultrasound Med. 2010;29:1833–6.
• 13. McMenamin ME, Fletcher CD. Mammary-type myofibroblastoma of soft tissue: a tumor closely related to spindle cell lipoma. Am J Surg Pathol. 2001;25:1022–9.