case_images: PMC11116817_01
case_images: Multimodal ultrasound performance of malignant glomus tumor in the breast. (A) Conventional gray-scale sonography revealed a mixed solid and cystic lump (arrow) in the breast. (B) Color Doppler flow imaging showed several blood flow signals that were observed in the periphery of the tumor (arrow). (C) Shear wave elastography showed a soft nodule (arrow) of the breast. (D) The contrast-enhanced ultrasound image captured 18 s after the injection of the contrast agent. (E) The contrast-enhanced ultrasound image captured 34 s after the injection of the contrast agent. (F) The contrast-enhanced ultrasound image captured 118 s after the injection of the contrast agent.
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case_images: PMC11116817_01_fonc-14-1393430-g001.jpg
case_images: f1
case_images: A mixed solid and cystic lump (measuring 64 mm x 37 mm x 49 mm) with an unclear boundary was found in the external upper quadrant of the left breast, and punctate echogenic foci was not detected on conventional ultrasonography ( Figure 1A ). System (ACR BI-RADS), this nodule was assigned to BR-4b category. Color Doppler blood flow imaging shows no significant blood flow signal within the nodule, with several blood flow signals observed in the periphery ( Figure 1B ). Spectral Doppler examination showed the resistance index to be 0.74. Figure 1C ). Furthermore, contrast-enhanced ultrasound (CE-US) was performed with the injection of SonoVue (Bracco, Milan, Italy). The lesion showed homogeneous hyperenhancement, and its enhancement pattern is centripetal, filling from the periphery toward the center ( Figures 1D-F ).
case_images: Mammography and contrast-enhanced CT (CE-CT) findings of malignant glomus tumor in the breast. (A) Axial mammography image showing a high-density lesion (arrow). (B) CE-CT revealed a poorly defined soft tissue mass (arrow).
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case_images: PMC11116817_01_fonc-14-1393430-g002.jpg
case_images: f2
case_images: A high-density mass ( Figure 2A ) measuring approximately 6.5 x 4.5 cm was identified in the upper outer quadrant of the left breast, displaying irregular morphology with clear margins. In addition, contrast-enhanced computed tomography (CE-CT) not only revealed a poorly defined soft tissue mass ( Figure 2B ) on the outer side of the left breast but also identified numerous lesions (the maximum diameter was 30 mm) in multiple organs, including the lungs, liver, left adrenal gland, both kidneys, pancreas, spleen, and colon.
case_images: Pathological findings of malignant glomus tumor in the breast. (A) Hematoxylin-eosin (magnification, x200). (B) Immunohistochemistry result showing the expression of Collage-IV (magnification, x200). (C) Immunohistochemistry result showing the expression of smooth muscle actin (magnification, x200). (D) Immunohistochemistry result showing the expression of desmin (magnification, x200). (E) Immunohistochemistry result showing the expression of signal transducer and activator of transcription 6 (magnification, x200). (F) Immunohistochemistry result showing the expression of Ki-67 (magnification, x200).
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case_images: PMC11116817_01_fonc-14-1393430-g003.jpg
case_images: f3
case_images: The histologic examination of the tumor showed that it consisted of abundant, regular, oval tumor cells with clear boundaries ( Figure 3A ). On immunohistochemistry, the tumor had strong Collage-IV ( Figure 3B ) and strong smooth muscle actin expression ( Figure 3C ), while desmin ( Figure 3D ), STAT6 ( Figure 3E ), epithelial membrane antigen, S-100 protein, CD31, and CD34 were negative. Figure 3F ) was 60%. Finally, the lesion was confirmed to be a MGT of the breast by histopathology.