Invasive Ductal Carcinoma Arising within a Fibroadenoma: A Case Report and Literature Review.

Kliti Pilika, Aldo Shpuza, Anita Pilika, Xhesika Xhetani
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Abstract

Background: Invasive ductal carcinoma (IDC) is the most common form of breast cancer, frequently presenting independently. Rarely, IDC arises within a fibroadenoma, a benign breast tumor typically associated with younger women. This case report and literature review aim to highlight the diagnostic challenges and clinical implications of finding IDC within a fibroadenoma. Case Presentation: A 36-year-old female patient presented with a dolent palpable mass in the right breast. Initial mammography described normal fibroglandular structures without significant findings. However, subsequent imaging ultrasound identified an 18x14 mm oval formation at the 9 o'clock position in the right breast, categorized as BI-RADS 3. Further histopathological evaluation after a biopsy confirmed the presence of a fibroadenoma with invasive ductal carcinoma, classified as Grade III with perivascular and neural infiltration. Discussion: The coexistence of IDC within a fibroadenoma poses significant diagnostic challenges due to the benign appearance of fibroadenomas on standard imaging modalities. This case emphasizes the need for a thorough evaluation and possible biopsy of fibroadenomas that exhibit atypical features or changes over time. Conclusion: This report underscores the importance of vigilance and comprehensive diagnostic strategies in cases of fibroadenomas, especially in patients with unusual or evolving lesions. The review of literature confirms that although rare, the occurrence of IDC within fibroadenomas can have significant implications for treatment and prognosis.
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纤维腺瘤中出现的浸润性导管癌:病例报告和文献综述。
背景:浸润性导管癌(IDC)是最常见的乳腺癌,经常单独发病。IDC发生在纤维腺瘤内的情况非常罕见,纤维腺瘤是一种良性乳腺肿瘤,通常与年轻女性有关。本病例报告和文献综述旨在强调在纤维腺瘤内发现 IDC 所带来的诊断挑战和临床影响。病例介绍:一名 36 岁的女性患者因右侧乳房可触及肿块而就诊。最初的乳房 X 光检查显示纤维腺体结构正常,无明显发现。活检后的进一步组织病理学评估证实,该肿块为纤维腺瘤伴浸润性导管癌,分级为 III 级,伴有血管周围和神经浸润。讨论由于纤维腺瘤在标准影像学检查中表现为良性,因此纤维腺瘤中同时存在IDC给诊断带来了巨大挑战。本病例强调了对表现出非典型特征或随时间发生变化的纤维腺瘤进行全面评估和活检的必要性。结论:本报告强调了对纤维腺瘤病例保持警惕和采取综合诊断策略的重要性,尤其是对病变不典型或不断发展的患者。文献综述证实,纤维腺瘤中出现 IDC 虽然罕见,但会对治疗和预后产生重大影响。
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