乳房错构瘤:大小差异与心理社会影响分析20例及1例例外病例报告回顾

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摘要

目的:乳腺错构瘤是一种罕见的无痛良性肿瘤,由于临床医生和病理学家的低估,文献综述有限。虽然生长缓慢,但由于乳房大小差异,诊断延误可能导致身体和心理上的影响。我们的研究目的是介绍乳房错构瘤的大小变化,从难以触及到严重的损害,以及由于身体畸形造成的心理社会影响,并附有病例报告。方法:我们回顾了2006年5月至2019年11月诊断为乳腺错构瘤的患者的人口统计学数据、放射学成像和大小变异性。结果:2006年至2019年,共有37例女性乳房错构瘤手术纳入研究,但仅有20例可检索到的数据,这些病例来自Liaquat国立医院和医学院卡拉奇普通外科。患者平均年龄35±11.92岁。临床大小为6.12±4.44,病理大小为7.88±4.23。最大记录尺寸为20x20cm。小于40年的病例占65%,大于45年的病例占35%。40岁以下和40岁以上分别进行乳腺超声和乳房x光检查。此外,1例出现皮肤坏死和坏死性伤口感染的患者接受了伤口清创,随后进行了缩小乳房成形术并切除了2.5 kg的错构瘤。结论:乳腺错构瘤是一种罕见的良性病变,可快速生长导致乳房畸形,必须密切观察或早期干预。超声在诊断中有重要作用,而细针穿刺的作用值得怀疑。
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Breast Hamartoma: A Size Diversity with Psychosocial Impact Analysis of 20 Cases and an Exceptional Case Report Review
Objectives: Breast hamartoma is a rare painless benign tumor with limited literature review due to underestimation by clinicians and pathologists. Though slowly growing, delay in diagnosis can lead to physical and psychological impact due to breast size discrepancy. Our study intend was to present breast hamartoma concerning size variance from hardly palpable to gross defacement and its psychosocial impact due to physical disfigurement, along with a case report. Method: We reviewed the demographic data, radiological imaging, and size variability of patients diagnosed with breast hamartoma between May 2006 and November 2019. Results: Overall, 37 cases of female breast hamartoma were operated from 2006 to 2019 but only 20 cases, whose data can be retrieved, in Liaquat National Hospital & Medical College, Karachi Department of General Surgery were included in the study. The mean age of patients was 35±11.92 years. The clinical and histopathological size was 6.12 ±4.44 and 7.88 ±4.23 respectively. Largest recorded size was 20x20cm. There are 65% of cases with less than 40 years and 35% cases with greater than 45 years. Breast ultrasound and Mammograms were performed below 40 years and greater than 40 years age of respectively. Furthermore, one case presented with skin necrosis and necrotizing wound infection underwent wound debridement and later on reduction mammoplasty with hamartoma excision of 2.5 kg. Conclusion: Breast hamartomas are rare benign lesions that may have rapid growth leading to breast disfigurement and must be addressed vigilantly either by close observation or early intervention. Ultrasound has a significant role in diagnosis whereas the role of fine-needle aspiration is questionable.
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