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case_images: (A and B) Mediolateral Oblique (MLO) View and Craniocaudal (CC) View mammograms of left breast. An oval circumscribed, predominantly fatty mass in the left breast Upper Outer Quadrant (UOQ). (C) magnified view of the lesion indicates a hyperdense mass with irregular shape and spiculated margin associated with coarse heterogeneous microcalcifications within it.
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case_images: Bilateral mammography showed an oval shaped circumscribed predominantly fatty mass measuring about 9.5 x 7.5 x 8 cm in the upper outer quadrant of the left breast (Fig. 1A, and B). In addition, a hyperdense mass measuring approximately 4.5 x 4 x 3 cm with irregular shape and spiculated margins associated with coarse heterogenous microcalcifications was seen within the mentioned lesion (Fig. 1C).
case_images: (A) Axial Turbo inversion recovery magnitude (TIRM), (B) Axial T1 fast spin echo, (C) Axial subtraction post contrast phase. An oval circumscribed mass of predominant internal fat intensity with an internal irregular spiculated mass of heterogenous T2 hypo intensity, heterogenous enhancement and medium/plateau kinetics.
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case_images: MRI evaluation confirmed the presence of an oval shaped circumscribed mass of predominant internal adipose intensity (nonenhancing) containing an internal irregular spiculated mass of heterogenous T2 hypo-intensity with heterogenous enhancement and medium/plateau kinetics (Fig. 2).
case_images: (A) Histopathologic view of the ultrasound guided biopsy specimen. Lobules and ducts of the mammary gland, and fibrous stroma and adipose tissue are located in a disorganized structure. Glands appear structurally normal with little proliferation. Neither cytoarchitectural atypia, nor significant mitosis is observed. (B) a view of invasive ductal carcinoma showing tumor clusters with focal tubule formation with desmoplastic stroma (the picture is for comparison and is not related to our patient). In contrast, invasive ductal carcinoma mostly has irregular borders and is comprised of atypical cells forming ducts and sheets with an infiltrative pattern in a desmoplastic stroma. Nuclear pleomorphism is evident, necrosis, and mitosis are also have been observed.
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case_images: (A) Postsurgical resection specimen (Gross pathology), (B) inside the resected tumor was yellow and white with areas of fat and calcifications, (C) mammographic view of the resected tumor.
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case_images: On gross examination, the mass appears as a benign, well-circumscribed breast tumor composed of randomly arranged and well-differentiated glandular and stromal mammary structures, and also adipose tissue and smooth muscles (Fig. 4).