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Infantile Hemangioma of the Breast: Case Presentation and Review of Literature
Bryan S. Armijo, MD; Arun K. Gosain, MD
Univ. Hospitals, Case Medical Center
2010-03-27
Presenter: Bryan S. Armijo, MD
Affidavit:
Director Name:
Author Category: Resident/Fellow
Presentation Category: Clinical
Abstract Category: Breast (Aesthetic and Recon.)
Background:
We present a case of a female infant who presents with a vascular lesion of the breast. The atypical presentation of this lesion contributed to the difficulty in making the ultimate diagnosis of an infantile hemangioma. This report highlights the work-up, differential diagnoses and treatment of breast infantile hemangiomas.
Methods:
A 1year old female infant presented to our clinic with a 6 x 6cm left breast mass. Mother reported a period of rapid growth of the mass since birth. Doppler exam was significant for an arterial signal and continuous venous signal. MRI of the lesion was suggestive of a hemangioma however; MRA/MRV was suggestive of an arteriovenous malformation (AVM). A subsequent, comprehensive review of the literature regarding presentation, diagnosis and treatment of infantile hemangiomas of the breast was performed.
Results:
Based on the Doppler exam and the MRA/MRV results suggesting an AVM, the lesion was selectively embolized and surgically excised 24 hours later via an inframammary approach. The histopathology confirmed an infantile hemangioma in the proliferative phase with positive GLUT-1 receptor staining.
Conclusion:
This report represents the potential incongruences seen when assimilating clinical and adjunctive diagnostic information in the case of a rapidly enlarging breast mass in an infant. A review of the literature confirms the rare occurrence of infantile hemangioma in the breast, thus making diagnosis even more challenging. However, clinical history is paramount and should an atypical presentation occur or diagnostic dilemmas exist, one may consider biopsy in these cases.
