OBJECTIVE: To present unusual case of rapidly growing breast fibroadenoma during pregnancy. CASE REPORT: Breast fibroadenomas are hormone-dependent tumors which can grow rapidly during pregnancy. We present a case of giant fibroadenoma, first detected before pregnancy, which grew rapidly under the influence of pregnancy hormones and was excised in the third trimester. CONCLUSION: Fibroadenomas are benign breast lesions in young women. They are hormone-dependent tumors, which can grow rapidly especially during pregnancy and/ or lactation and imitate malignancy. In each case of a newly created breast lesion, it is necessary to proceed responsibly to the clinical examination, which is a base for further decision concerning the necessity of taking a bio­psy for histological verification.

• Klíčová slova
• breast fibroadenoma, lactation, phyllodes tumor, pregnancy,
• MeSH
• cystosarcoma phyllodes * MeSH
• fibroadenom * chirurgie   MeSH
• kojení MeSH
• lidé MeSH
• nádory prsu * chirurgie   MeSH
• prsy chirurgie   MeSH
• těhotenství MeSH
• Check Tag
• lidé MeSH
• těhotenství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

UNLABELLED: The presence of enlarged and pleomorphic nuclei is usually regarded as a feature of malignancy, but it may on occasion be seen in benign lesions such as mammary fibroadenomas. We present such a case of fibroadenoma occurring in a 37-year-old woman presenting with a self-palpable right breast mass. Histological examination of the tumor revealed the presence of multi and mononucleated giant cells with pleomorphic nuclei. The recognition of the benign nature of these cells is necessary for differential diagnosis from malignant lesions of the breast. KEYWORDS: fibroadenoma - pleomorphic stromal cells - atypia - breast.

• MeSH
• buňky stromatu patologie   MeSH
• dospělí MeSH
• fibroadenom patologie   MeSH
• lidé MeSH
• nádory prsu patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The authors present a series of 13 fibroepithelial neoplasms involving anogenital mammary-like glands, all occurring in 12 female patients, whose age at diagnosis ranged from 30 to 51 years (mean, 38 y; median, 42 y). All women presented with a solitary asymptomatic nodule in the vulva (n=8), perineum (n=2), or near the anus (n=2) ranging in size from 1.5 to 4.5 cm. Microscopically, 8 lesions were classified as fibroadenoma, and 5, including 1 recurrent tumor, as phyllodes tumor, of which 1 was benign and 4 low-grade malignant. In addition to conventional findings, we describe several hitherto unreported features including juvenile fibroadenoma-like proliferation, fibroadenoma with lactation change, and pseudoangiomatous stromal hyperplasia with multinucleated stromal giant cells in a patient with neurofibromatosis, type 1 all constituting potential diagnostic pitfalls, which are best averted by using the same approach to diagnosis as for their analogous mammary counterparts.

• MeSH
• cystosarcoma phyllodes komplikace   metabolismus   patologie   MeSH
• dospělí MeSH
• fibroadenom komplikace   metabolismus   patologie   MeSH
• imunohistochemie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mléčné žlázy lidské metabolismus   patologie   MeSH
• nádory anu komplikace   metabolismus   patologie   MeSH
• nádory ženských pohlavních orgánů komplikace   metabolismus   patologie   MeSH
• neurofibromatóza 1 komplikace   patologie   MeSH
• obrovské buňky patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Lesions affecting anogenital mammary-like glands (AGMLG) are histopathologically very similar to those seen in the breast but whether this morphological similarity is also reflected at the genetic level is unknown. To compare the underlying molecular mechanisms in lesions of AGMLG and their mammary counterparts, we analyzed the mutational profile of 16 anogenital neoplasms including 5 hidradenomas papilliferum (HP), 1 lesion with features of HP and fibroadenoma (FA), 7 FA, 3 phyllodes tumors (PhT)) and 18 analogous breast lesions (6 intraductal papillomas (IDP), 9 FA, and 3 PhT) by high-coverage next generation sequencing (NGS) using a panel comprising 50 cancer-related genes. Additionally, all cases were analyzed for the presence of a mutation in the MED12 gene. All detected mutations with allele frequencies over 20% were independently validated by Sanger sequencing (concordance: 100%). Mutations in PIK3CA, AKT1, MET, ABL1 and TP53 genes were found in lesions of AGMLG and also their mammary counterparts. The PI3K-AKT cascade plays a role in tumors arising at both sites. It appears that some histopathologically similar anogenital and breast lesions develop along similar molecular pathways.

• Klíčová slova
• AKT1, Anogenital mammary-like glands, Breast, Fibroadenoma, Hidradenoma papilliferum, Intraductal papilloma, PIK3CA, Phyllodes tumor, Vulva,
• MeSH
• adenomy potních žláz metabolismus   patologie   MeSH
• cystosarcoma phyllodes metabolismus   patologie   MeSH
• fibroadenom metabolismus   patologie   MeSH
• fosfatidylinositol-3-kinasy třídy I metabolismus   MeSH
• fosfatidylinositol-3-kinasy metabolismus   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mutace genetika   MeSH
• nádory prsu genetika   patologie   MeSH
• nádory vulvy patologie   MeSH
• papilom intraduktální metabolismus   patologie   MeSH
• prsy patologie   MeSH
• senioři MeSH
• vysoce účinné nukleotidové sekvenování metody   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• fosfatidylinositol-3-kinasy třídy I MeSH
• fosfatidylinositol-3-kinasy MeSH
• PIK3CA protein, human MeSH Prohlížeč

Fibroadenomas are common, benign breast tumors that usually affect women in the second and third decade of life. Giant fibroadenomas often cause significant concern for the patient or family regarding malignant potential and altered breast development. Most fibroadenomas are benign. Local excision of small lesions through a circumareolar or inframammary incision rather than radical surgery is appropriate. Breast ultrasound represents the most commonly used imaging modality for the study of pediatric female breast masses and fibroadenomas. Detailed descriptions of the sonographic appearances of fibroadenomas in young girls are sparse. We believe that surgical treatment for the patient should include tumor extirpation and immediate restoration of breast appearance, minimizing visible scars, protection of the developing breast bud, nipple, and areola. This modality reduces psychosocial comorbidity.

• MeSH
• diferenciální diagnóza MeSH
• fibroadenom diagnóza   patologie   chirurgie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie MeSH
• mamoplastika metody   MeSH
• mladiství MeSH
• nádory prsu diagnóza   patologie   chirurgie   MeSH
• ultrasonografie prsů MeSH
• Check Tag
• lidé MeSH
• mladiství MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

Anogenital mammary-like glands (AGMLG) are nowadays considered a normal component of the anogenital area. Lesions affecting AGMLG are similar to those seen in breast. We present a case of a complex neoplastic lesion of the AGMLG with mixed features of fibroadenoma and hidradenoma papilliferum combined with pseudoangiomatous stromal hyperplasia. Multinucleated cells were detected in the pseudoangiomatous stromal hyperplasia areas as seen in some patients with neurofibromatosis type 1. The neoplasm is similar to rare mammary composite neoplasms that feature simultaneously patterns of a fibroepithelial neoplasms and intraductal papilloma.

• MeSH
• akrospirom patologie   MeSH
• angiomatóza patologie   MeSH
• fibroadenom patologie   MeSH
• hyperplazie patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory komplexní a smíšené patologie   MeSH
• nádory potních žláz patologie   MeSH
• nádory vulvy patologie   MeSH
• nemoci prsů patologie   MeSH
• obrovské buňky patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

• MeSH
• adenofibrom diagnostické zobrazování   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• fibrocystická nemoc prsu diagnostické zobrazování   MeSH
• lidé středního věku MeSH
• lidé MeSH
• mamografie MeSH
• mladiství MeSH
• nádory prsu diagnostické zobrazování   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

• Klíčová slova
• ADENOFIBROMA *, BREAST/neoplasms *,
• MeSH
• adenofibrom * MeSH
• cystosarcoma phyllodes * MeSH
• fibroadenom * MeSH
• lidé MeSH
• nádory prsu * MeSH
• prsy * MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

Anogenital mammary-like glands represent a normal anatomic constituent of the anogenital area and may give rise to many benign and malignant tumors that morphologically mimic similar breast diseases. The literature review is complemented by a description of 286 cases of benign tumors and tumor-like processes in the mammary-like glands. The paper presents the clinical and morphological characteristics of papillary hidradenoma, fibroadenoma, benign phyllodes tumor, lactating adenoma, sclerosing adenosis, pseudoangiomatous stromal hyperplasia, etc.

Маммароподобные железы являются нормальным анатомическим компонентом аногенитальной области и могут давать начало многочисленным доброкачественным и злокачественным опухолям, морфологически напоминающим аналогичные заболевания молочной железы. Обзор литературы дополнен описанием 286 случаев доброкачественных опухолей и опухолеподобных процессов маммароподобных желез. В статье представлена клинико-морфологическая характеристика папиллярной гидраденомы, фиброаденомы, доброкачественной филлоидной опухоли, лактирующей аденомы, склерозирующего аденоза, псевдоангиоматозной стромальной гиперплазии и др.

• MeSH
• adenom diagnóza   patologie   MeSH
• akrospirom diagnóza   patologie   MeSH
• cystosarcoma phyllodes diagnóza   patologie   MeSH
• fibroadenom diagnóza   patologie   MeSH
• laktace fyziologie   MeSH
• lidé MeSH
• nádory prsu klasifikace   diagnóza   patologie   MeSH
• nádory klasifikace   diagnóza   patologie   MeSH
• prsy patologie   MeSH
• Světová zdravotnická organizace MeSH
• Check Tag
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Pseudoangiomatous stromal hyperplasia (PASH), first reported in 1986, is nowadays a well-recognized change in the breast. We present three cases of lesions involving anogenital mammary-like glands demonstrating this feature. All patients were females (ages, 42, 43, and 53 years). Each presented with a solitary, 1.5- to 2-cm asymptomatic nodule. Locations included the perianal area, perineum, and labium majus. Histopathologically, one lesion was classified as low-grade phyllodes tumor, another as fibroadenoma, and in the remaining case PASH was found in the background of mild hyperplasia of anogenital mammary-like glands and substantial lipomatous metaplasia. In all lesions, PASH had an identical appearance to that in the breast, that is open, slit-like, often anastomosing channels devoid of erythrocytes and lined by discontinuous, often attenuated, inconspicuous cells without atypia or mitotic activity set in a hyalinized collagenous stroma. Quantitatively, PASH ranged in the above cases, forming a relatively small focus in the fibroadenoma and being quite extensive in the remaining two cases. In the phyllodes tumor, PASH areas exhibited focal hypercellularity and presence of myoid cells. In none of the cases were there cells with intranuclear inclusions or multinucleated cells. The lesions were surgically excised. Two patients with follow-up were disease-free at one and three years after the operation. As to our knowledge, PASH has not been previously described in the anogenital area, this feature seems to have been either overlooked or is genuinely rare in this location. It may occur in a preexisting lesion of anogenital mammary-like glands or may apparently by itself produce a clinically detectable lesion. The clinicopathologic features of PASH in the anogenital area seem to be identical to those in the breast.

• MeSH
• buňky stromatu metabolismus   patologie   MeSH
• cystosarcoma phyllodes metabolismus   patologie   MeSH
• diferenciální diagnóza MeSH
• dospělí MeSH
• fibroadenom metabolismus   patologie   MeSH
• fibrom metabolismus   patologie   MeSH
• hyperplazie metabolismus   patologie   MeSH
• imunohistochemie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mnohočetné primární nádory patologie   MeSH
• nádory anu metabolismus   patologie   MeSH
• nádory prsu patologie   MeSH
• nádory vulvy metabolismus   patologie   MeSH
• perineum patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH