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Case Report
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| Vascular stromal mass: A unique histological entity mimics malignancy on breast magnetic resonance imaging | ||||||
| Jon Gerry1, James Kuo2, Kristin Jensen3, Irene Wapnir1 | ||||||
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1MD, Department of Surgery, Stanford Hospital and Clinics, Stanford, CA, USA.
2MD, Department of Radiology, Stanford Hospital and Clinics, Stanford, CA, USA. 3MD, Department of Pathology, Stanford Hospital and Clinics, Stanford, CA, USA. | ||||||
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| How to cite this article: |
| Gerry J, Kuo J, Jensen K, Wapnir I. Vascular stromal mass: A unique histological entity mimics malignancy on breast magnetic resonance imaging. International Journal of Case Reports and Images 2013;4(8):436–439. |
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Abstract
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Introduction:
Breast magnetic resonance imaging (MRI) is gaining routine acceptance for screening of high-risk patients and is used selectively in the diagnostic work-up of women with undetermined lesions or breast cancer. Malignant masses can be differentiated from benign lesions based on margin characteristics, dynamic enhancement features and size.
Case Report: A 58-year-old female underwent an excisional biopsy for a non-palpable, MRI-detected mass lesion with irregular borders. The lesion demonstrated marked enhancement on postcontrast images with rapid wash-in and plateau delay phase kinetics. After excision, a 1.5-cm vascular stromal mass (VSM) comprised of admixed fibrous and fatty tissue with a non-organized proliferation of ectatic blood vessels lined by a single layer of cytologically bland endothelial cells was identified. The described pathological entity is histologically distinct from pseudoangiomatous stromal hyperplasia hemangioma or angiolipoma. The MRI enhancement features of the VSM mimicked those of carcinoma, attributable to the characteristic ectatic blood vessels. Moreover, the admixed fibro-fatty stroma comprising the mass is otherwise radiographically and sonographically similar to adjacent breast tissue, making it undetectable by mammography and ultrasound. Conclusion: The VSM is a unique histological entity visualized only by breast MRI. Its appearance is indistinguishable from malignant lesions on MRI and so requires a biopsy. | |
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Keywords:
Vascular stromal mass (VSM), Pseudoangiomatous stromal hyperplasia (PASH), Hemangioma, Angiolipoma
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Author Contributions
Jon Gerry – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published James Kuo – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article Kristin Jensen – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article Irene Wapnir – Conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Critical revision of the article, Final approval of the version to be published |
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Guarantor of submission
The corresponding author is the guarantor of submission. |
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Source of support
None |
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Conflict of interest
Authors declare no conflict of interest. |
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Copyright
© Jon Gerry et al. 2013; This article is distributed the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any means provided the original authors and original publisher are properly credited. (Please see Copyright Policy for more information.) |
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