Breast within a Breast appearance: Breast hamartoma by Zineb IZI in Journal of Clinical Case Reports Medical Images and Health Sciences

Breast within a Breast appearance: Breast hamartoma by Zineb IZI in Journal of Clinical Case Reports Medical Images and Health Sciences

Abstract

Hamartomas, also known as fibroadenolipomas, are uncommon, benign lesions that can arise in a variety of organs, including the breast.The masses are connected with distinct mammographic and sonographic characteristics that indicate the tissue components' diversity.

Keys words :  Hamartomas, Breast, Mammography, US

Case Report :

We report the case of a 47-year-old female patient who presented with a palpable mass and had no family history of breast cancer. The physical examination found a soft and mobile nodular lesion of the medial lower right breast with no cutaneous changes.

There was no axillary or supraclavicular lymphadenopathies found.

Mammography showed a well-circumscribed oval solid mass surrounded by a thin pseudocapsule with a mixed density (figure 2). with no micro- or macrocalcifications.

Ultrasound revealed a well-encapsulated and well-defined heterogenous mass with hypoechoic and hyperechoic components, laying parallel to the skin plane, with the classic description of "the breast within a breast appearance" (figure 1).


Figure 1 : ultrasonography of the right breast shows a well defined oval formation laying parallel to the skin plan, with inhomogeneous echo structure.


Figure 2 : mammography on cranio-caudal and oblique projection schows a round formation of the medial lower quadrant of the right breast ; whitch is inhomogenous with a thin radio-opaque pseudocapsule.

Commentry

Breast hamartomas are rare benign breast tumors well defined with a slow development. They are also known as fibroadenolipomas or or adenolipoma (1). They are generally encountered in middle-aged women over the age of 35, with an overall incidence of 4.8% benign breast lesions; (2) However, the incidence is believed to have increased due to breast cancer screening programs (3).

In terms of pathology, all hamartoma constituents are normal components of normal breast tissue. The terminology Fibroadenolipoma refers to a benign process of fibrous, glandular, and fatty tissue development enclosed by a thin capsule of connective tissue,

Because of the considerable variation in adipose and fibrous tissue components, the presentations of hamartomas in the Ultrasound vary greatly. They usually appear as firm, well-defined circular shapes parallel to the skin plane with heterogeneous echo structure with hypoechoic and hyperechoic intermingled regions, indicating the presence of epithelial fibrous and adipose tissues (4).

On mammography, hamartomas are typically observed as oval or circular forms that are heterogeneous, with radio-opaque and radiotransparent regions indicating the presence of tissues with varying densities. A thin radio-opaque pseudocapsule separates them from the adjacent breast tissue (5).
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